Provider Demographics
NPI:1598219578
Name:JOHNSON, HILLARY SETH (CPNP)
Entity Type:Individual
Prefix:MS
First Name:HILLARY
Middle Name:SETH
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 ATLANTIC AVE
Mailing Address - Street 2:MARBLEHEAD PEDIATRICS
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-3042
Mailing Address - Country:US
Mailing Address - Phone:781-631-7800
Mailing Address - Fax:
Practice Address - Street 1:70 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-3042
Practice Address - Country:US
Practice Address - Phone:781-631-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-08
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2276995363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics