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General NPI Number Information
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NPI Number | 1114786035
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Entity Type | Individual
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Provider Name | ANNA JOHNSON PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/14/2024
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 4103 CHAPMAN HWY
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City | KNOXVILLE
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State | TN
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Zip | 37920
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Country | US
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Telephone | 865-205-9145
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Fax |
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Provider Business Mailing Address
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Address Line | 517 W 2ND AVE
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City | LENOIR CITY
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State | TN
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Zip | 37771-2313
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 5882
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License Number State | TN
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