Healthcare Provider Details

I. General information

NPI: 1831032424
Provider Name (Legal Business Name): PAMELA MARIE JOHNSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10506 MONTGOMERY RD STE 200A
MONTGOMERY OH
45242-4400
US

IV. Provider business mailing address

10506A MONTGOMERY RD STE 200
MONTGOMERY OH
45242-4402
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-2343
  • Fax: 513-865-9916
Mailing address:
  • Phone: 513-246-4054
  • Fax: 513-865-9916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number249708
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: