Johnson, Shannon Lynne
Johnson, Shannon Lynne is an individual health care provider with primary practice located at 10 Gove St , East Boston MA 02128-1920. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Johnson, Shannon Lynne can be contacted via phone (617) 569-5800.Contact Information
Primary practice address
10 Gove St
East Boston MA 02128-1920
Phone: (617) 569-5800
Fax: (617) 568-4780
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 262820 | Massachusetts |
Profile Details
| NPI number | 1417158296 |
|---|---|
| LBN Legal business name | Johnson, Shannon Lynne |
| Credentials | NP-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 30th, 2007 |
| Last updated | Feb 1st, 2012 - about 12 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 | 1417158296 | NPPES |
| Massachusetts | MEDICAID | 0714810 |
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