MEDICARE: MS. ELAINE MARIE JOHNSON NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	043163-23	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194796730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELAINE MARIE JOHNSON NP

Provider Business Mailing Address
First Line	:	243 ELM ST
Second Line	:
City	:	CLAREMONT
State	:	NH
Zip	:	03743
Country	:	US
Telephone Number	:	603-863-6400
Fax Number	:	603-863-7800

Provider Business Practice Location Address
First Line	:	17 MAIN STREET
Second Line	:	VALLEY REGIONAL PRIMARY CARE PHYSICIANS
City	:	NEWPORT
State	:	NH
Zip	:	03773
Country	:	US
Telephone Number	:	603-863-6400
Fax Number	:	603-863-7800

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	02/22/2012

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