MEDICARE: TARMA JEAN JOHNSON FNP-BC

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	363L00000X	Nurse Practitioner	MA186837	MA

General Provider Information

NPI Number	:	1982781977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARMA JEAN JOHNSON FNP-BC

Provider Business Mailing Address
First Line	:	1575 BLUE HILL AVE
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02126-2122
Country	:	US
Telephone Number	:	617-898-9042
Fax Number	:	617-296-8701

Provider Business Practice Location Address
First Line	:	1575 BLUE HILL AVE
Second Line	:
City	:	MATTAPAN
State	:	MA
Zip	:	02126-2122
Country	:	US
Telephone Number	:	617-898-9057
Fax Number	:	617-296-5408

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	03/25/2016

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