Provider Demographics
NPI:1578924130
Name:JOHNSON, WILLIAM JOSHUA (MSN, FNP-C, PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JOSHUA
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MSN, FNP-C, PMHNP-BC
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Mailing Address - Street 1:PO BOX 1629
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-1629
Mailing Address - Country:US
Mailing Address - Phone:910-778-5455
Mailing Address - Fax:866-423-7783
Practice Address - Street 1:812 CANDY PARK RD STE 6101-A
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-9120
Practice Address - Country:US
Practice Address - Phone:910-778-5455
Practice Address - Fax:910-208-0655
Is Sole Proprietor?:No
Enumeration Date:2016-03-10
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5008388363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty