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NPI Code Detail

MEDICARE: MICHAELA JOHNSON FNP-C

MEDICARE: MICHAELA JOHNSON FNP-C
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
1363LF0000XFamily Nurse PractitionerF06191029MA
2363L00000XNurse PractitionerRN2327072MA

General Provider Information

NPI Number : 1598327702
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAELA JOHNSON FNP-C
Provider Business Mailing Address
First Line : 41 MALL RD LAHEY HOSPITAL AND MEDICAL CENTER
Second Line :
City : BURLINGTON
State : MA
Zip : 01805-0001
Country : US
Telephone Number : 781-744-8400
Fax Number : 781-744-5245
Provider Business Practice Location Address
First Line : 140 COMMONWEALTH AVE
Second Line :
City : CHESTNUT HILL
State : MA
Zip : 02467-3858
Country : US
Telephone Number : 516-456-8142
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2019
Last Update Date : 10/14/2019

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