Provider Demographics
NPI:1629307541
Name:JOHNSON, PHOEBE A (DNP, ARNP)
Entity Type:Individual
Prefix:MS
First Name:PHOEBE
Middle Name:A
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DNP, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1369 OLD MILL LANE
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-4623
Mailing Address - Country:US
Mailing Address - Phone:352-540-6800
Mailing Address - Fax:352-754-4132
Practice Address - Street 1:300 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-3320
Practice Address - Country:US
Practice Address - Phone:352-540-6800
Practice Address - Fax:352-754-4132
Is Sole Proprietor?:No
Enumeration Date:2009-12-24
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9165634363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily