Johansen, Brett
Johansen, Brett is an individual health care provider with primary practice located at 1210 Nw 16Th St , Fruitland ID 83619-2202. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Johansen, Brett can be contacted via phone (208) 452-9881.Contact Information
Primary practice address
1210 Nw 16Th St
Fruitland ID 83619-2202
Phone: (208) 452-9881
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA-1308 | Idaho |
Profile Details
| NPI number | 1982074696 |
|---|---|
| LBN Legal business name | Johansen, Brett |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 7th, 2015 |
| Last updated | Oct 7th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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