Provider Demographics
NPI:1710078118
Name:COOTE-JOHNSON, SHARON (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:COOTE-JOHNSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3206 COLLINS ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735
Mailing Address - Country:US
Mailing Address - Phone:301-203-7223
Mailing Address - Fax:202-745-8500
Practice Address - Street 1:50 IRVING ST N.W.
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422
Practice Address - Country:US
Practice Address - Phone:202-745-8000
Practice Address - Fax:202-745-8500
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPA251363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical