Provider Demographics
NPI:1710256854
Name:JOHNSON, ELLEN MARGARET (RPN)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:MARGARET
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 MYERS CORNERS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WAPPINGERS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-5041
Mailing Address - Country:US
Mailing Address - Phone:845-897-6700
Mailing Address - Fax:
Practice Address - Street 1:2010 ROUTE 52
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-3507
Practice Address - Country:US
Practice Address - Phone:845-897-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY357957-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool