Johnson, Susan R

Johnson, Susan R is an individual health care provider with primary practice located at 501 6Th Ave S , St Petersburg FL 33701-4634. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Johnson, Susan R can be contacted via phone (727) 767-8181.

Contact Information

Primary practice address
501 6Th Ave S St Petersburg FL 33701-4634
Phone: (727) 767-8181
Fax: (727) 767-8030
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X ARNP3072252 Florida

Profile Details

NPI number 1316957046
LBN Legal business name Johnson, Susan R
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 8th, 2006
Last updated Feb 10th, 2016 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1316957046 NPPES
Florida MEDICAID 303458500
Florida Other Y012G

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