Provider Demographics
NPI:1083913669
Name:JOHNSON, PERPETUA BEJOSE (CRNP-F)
Entity Type:Individual
Prefix:MRS
First Name:PERPETUA
Middle Name:BEJOSE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CRNP-F
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1593
Mailing Address - Street 2:
Mailing Address - City:LANDOVER
Mailing Address - State:MD
Mailing Address - Zip Code:20785-0593
Mailing Address - Country:US
Mailing Address - Phone:301-434-8183
Mailing Address - Fax:301-348-2894
Practice Address - Street 1:7411 RIGGS RD STE 404
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-4246
Practice Address - Country:US
Practice Address - Phone:301-434-8183
Practice Address - Fax:301-434-8289
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR148142363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner