Provider Demographics
NPI:1508049719
Name:JOHNSON, TULANI AIN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:TULANI
Middle Name:AIN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:126 S STATE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-3524
Mailing Address - Country:US
Mailing Address - Phone:215-579-9774
Mailing Address - Fax:215-579-9774
Practice Address - Street 1:126 S STATE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-3524
Practice Address - Country:US
Practice Address - Phone:215-579-9774
Practice Address - Fax:215-579-9774
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA053291363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant