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General NPI Number Information
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NPI Number | 1225004336
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Entity Type | Individual
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Provider Name | LYNNE M JOHNSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 06/09/2017
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Provider Practice Location Address
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Address Line | 348 MAIN ST
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City | GREENVILLE
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State | PA
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Zip | 16125-2608
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Country | US
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Telephone | 724-588-5250
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Fax | 724-588-5253
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Provider Business Mailing Address
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Address Line | PO BOX 716 100 SHENANGO AVENUE
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City | SHARON
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State | PA
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Zip | 16146-0716
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Country | US
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Telephone | 724-588-5250
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Fax | 724-588-5253
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD421255
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License Number State | PA
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