Provider Demographics
NPI:1558684423
Name:JOHNSON, EUGENIA MELIGAKES (FNP-BC)
Entity Type:Individual
Prefix:
First Name:EUGENIA
Middle Name:MELIGAKES
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 N MILDRED ST
Mailing Address - Street 2:
Mailing Address - City:RANSON
Mailing Address - State:WV
Mailing Address - Zip Code:25438-5552
Mailing Address - Country:US
Mailing Address - Phone:304-724-6091
Mailing Address - Fax:304-725-7204
Practice Address - Street 1:1212 N MILDRED ST
Practice Address - Street 2:
Practice Address - City:RANSON
Practice Address - State:WV
Practice Address - Zip Code:25438-5552
Practice Address - Country:US
Practice Address - Phone:304-724-6091
Practice Address - Fax:304-725-7204
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV39832363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily