Provider Demographics
NPI:1083778518
Name:LEHMANN, JOHANNA (PA-C)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:
Last Name:LEHMANN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S PICKENS RD
Mailing Address - Street 2:
Mailing Address - City:HELVETIA
Mailing Address - State:WV
Mailing Address - Zip Code:26224
Mailing Address - Country:US
Mailing Address - Phone:304-924-5453
Mailing Address - Fax:304-924-5496
Practice Address - Street 1:100 S PICKENS RD
Practice Address - Street 2:
Practice Address - City:HELVETIA
Practice Address - State:WV
Practice Address - Zip Code:26224
Practice Address - Country:US
Practice Address - Phone:304-924-5453
Practice Address - Fax:304-924-5496
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV820363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1083778518Medicaid