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NPI Code Detail

MEDICARE: JANAE JOHNSON

MEDICARE: JANAE JOHNSON
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
1363A00000XPhysician AssistantGA
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1386392165
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANAE JOHNSON
Provider Business Mailing Address
First Line : 6178 COLLEGE STATION DR
Second Line :
City : WILLIAMSBURG
State : KY
Zip : 40769-1372
Country : US
Telephone Number : 800-343-1609
Fax Number :
Provider Business Practice Location Address
First Line : 200 VESTAVIA PKWY STE 2400
Second Line :
City : VESTAVIA
State : AL
Zip : 35216-3797
Country : US
Telephone Number : 205-490-3931
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2022
Last Update Date : 01/27/2026

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Directions to “ JANAE JOHNSON ” Practice Location

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