Johnson, Beverly K
Johnson, Beverly K is an individual health care provider with primary practice located at 510 S Main St Suite B, Baxley GA 31513-0153. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Johnson, Beverly K can be contacted via phone (912) 367-0653.Contact Information
Primary practice address
510 S Main St Suite B
Baxley GA 31513-0153
Phone: (912) 367-0653
Fax: (912) 367-0656
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN106778 | Georgia |
Profile Details
| NPI number | 1881605806 |
|---|---|
| LBN Legal business name | Johnson, Beverly K |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 11th, 2006 |
| Last updated | Feb 4th, 2010 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881605806 | NPPES |
| Georgia | MEDICAID | 000906881C |
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