Provider Demographics
NPI:1639128952
Name:JOHNSON, CATHERINE JANE (FAMILY NURSE PRACTIT)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:JANE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:FAMILY NURSE PRACTIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 TUNNEL RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805
Mailing Address - Country:US
Mailing Address - Phone:828-298-7911
Mailing Address - Fax:
Practice Address - Street 1:1100 TUNNEL RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805
Practice Address - Country:US
Practice Address - Phone:828-298-7911
Practice Address - Fax:828-299-5889
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC54858363L00000X
NC054858363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner