Johnson-Mason, Tyreasea Anicha

Johnson-Mason, Tyreasea Anicha is an sole proprietor health care provider with primary practice located at 215 Highland Ave Ste 100 , Haddon Township NJ 08108-2634. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Johnson-Mason, Tyreasea Anicha can be contacted via phone (609) 350-4792.

Contact Information

Primary practice address
215 Highland Ave Ste 100 Haddon Township NJ 08108-2634
Phone: (609) 350-4792
Fax: (856) 823-1922
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X SP012833 Pennsylvania
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 26NJ00429100 New Jersey

Profile Details

NPI number 1003250101
LBN Legal business name Johnson-Mason, Tyreasea Anicha
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 19th, 2013
Last updated Apr 15th, 2020 - about 5 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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Identifiers

StateTypeNumberIssuer
All States NPI 1003250101 NPPES
New Jersey MEDICAID 0379077
New Jersey Other 1003250101

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