Provider Demographics
NPI:1730645573
Name:JOHNSON, HONESTY JONATHAN-HANSEL
Entity Type:Individual
Prefix:
First Name:HONESTY
Middle Name:JONATHAN-HANSEL
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 N HARRISON AVE STE 200-39
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-3092
Mailing Address - Country:US
Mailing Address - Phone:888-604-6398
Mailing Address - Fax:919-446-1544
Practice Address - Street 1:1903 N HARRISON AVE STE 200-39
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-3092
Practice Address - Country:US
Practice Address - Phone:888-604-6398
Practice Address - Fax:919-446-1544
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)