Provider Demographics
NPI:1437246493
Name:JOHNSON, PAMELA ELIZABETH (ADOULT ARNP)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ELIZABETH
Last Name:JOHNSON
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Gender:F
Credentials:ADOULT ARNP
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Mailing Address - Street 1:1502 W NC HIGHWAY 54
Mailing Address - Street 2:STE 103
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5572
Mailing Address - Country:US
Mailing Address - Phone:919-354-0840
Mailing Address - Fax:919-908-8167
Practice Address - Street 1:3161 CRYSTAL WAY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-4230
Practice Address - Country:US
Practice Address - Phone:754-423-4611
Practice Address - Fax:954-885-9305
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-09
Last Update Date:2017-02-21
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Provider Licenses
StateLicense IDTaxonomies
NC5009253363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health