Provider Demographics
NPI:1033340799
Name:JOHNSON, FLOYD JOSEPH III (NP)
Entity Type:Individual
Prefix:
First Name:FLOYD
Middle Name:JOSEPH
Last Name:JOHNSON
Suffix:III
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5999 HARPERS FARM RD STE W250
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3017
Mailing Address - Country:US
Mailing Address - Phone:410-772-8822
Mailing Address - Fax:410-772-9274
Practice Address - Street 1:5999 HARPERS FARM RD STE W250
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3017
Practice Address - Country:US
Practice Address - Phone:410-772-8822
Practice Address - Fax:410-772-9274
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1041999363LA2100X
MDR229482363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD777156800Medicaid