Johnson, Wanda Sue

Johnson, Wanda Sue is an sole proprietor health care provider with primary practice located at 4228 Garrett Rd , Durham NC 27707-3430. She recently has 2 registered licenses in different health care specialties including Suppliers / Prosthetic/Orthotic Supplier, Other Service Providers / Specialist. Other Service Providers / Specialist is her primary health care specialty. Johnson, Wanda Sue can be contacted via phone (919) 489-7408.

Contact Information

Primary practice address
4228 Garrett Rd Durham NC 27707-3430
Phone: (919) 489-7408
Fax: (919) 490-5909
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Prosthetic/Orthotic Supplier 335E00000X North Carolina
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1043331440
LBN Legal business name Johnson, Wanda Sue
Credentials RMF/CMF
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 3rd, 2007
Last updated Jul 11th, 2007 - about 17 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 1043331440 NPPES
North Carolina MEDICAID 7795110

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