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General NPI Number Information
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NPI Number | 1427429620
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Entity Type | Individual
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Provider Name | HANNAH JOHNSON PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/13/2015
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Last Update Date | 02/09/2022
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Provider Practice Location Address
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Address Line | 4359 NEW SHEPHERDSVILLE RD UNIT 245
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City | BARDSTOWN
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State | KY
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Zip | 40004-8004
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Country | US
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Telephone | 502-350-5492
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Fax | 502-350-5822
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Provider Business Mailing Address
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Address Line | PO BOX 936
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City | LONDON
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State | KY
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Zip | 40743-0936
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Country | US
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Telephone | 606-330-7835
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Fax | 606-330-7825
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | TC438
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA2044
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License Number State | KY
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