Healthcare Provider Details

I. General information

NPI: 1396656385
Provider Name (Legal Business Name): ALEXANDRIA LYNAE JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

274 EASTCHESTER DR STE 130
HIGH POINT NC
27262-7721
US

IV. Provider business mailing address

131 ENTERPRISE RD
JOHNSTOWN NY
12095-3326
US

V. Phone/Fax

Practice location:
  • Phone: 336-823-1647
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1763
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: