MEDICARE: MS. VERONICA L. JOHNSON N.P.

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	R092757	MD

General Provider Information

NPI Number	:	1588730717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VERONICA L. JOHNSON N.P.

Provider Business Mailing Address
First Line	:	3414 FORESTLEIGH DR
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-2206
Country	:	US
Telephone Number	:	410-581-1150
Fax Number	:

Provider Business Practice Location Address
First Line	:	6501 N CHARLES ST
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21204-6819
Country	:	US
Telephone Number	:	410-938-3475
Fax Number	:	410-938-9474

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

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	07/08/2007

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