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General NPI Number Information
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NPI Number | 1528221520
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Entity Type | Individual
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Provider Name | ANDREA CHRISTINE JOHNSON PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 04/01/2011
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Provider Practice Location Address
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Address Line | 10 EAST 31ST STREET
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City | KEARNEY
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State | NE
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Zip | 68847
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Country | US
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Telephone | 308-865-7997
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Fax |
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Provider Business Mailing Address
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Address Line | 8055 O STREET SUITE 300
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City | LINCOLN
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State | NE
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Zip | 68510
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Country | US
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Telephone | 402-421-8096
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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 | 1389
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License Number State | NE
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