Provider Demographics
NPI:1760883359
Name:WHITE EAGLE - JOHNSON, JANICE (CPC)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:WHITE EAGLE - JOHNSON
Suffix:
Gender:F
Credentials:CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 96
Mailing Address - Street 2:406 E STREET EAST
Mailing Address - City:POPLAR
Mailing Address - State:MT
Mailing Address - Zip Code:59255-0096
Mailing Address - Country:US
Mailing Address - Phone:406-768-6663
Mailing Address - Fax:
Practice Address - Street 1:406 E STREET EAST
Practice Address - Street 2:
Practice Address - City:POPLAR
Practice Address - State:MT
Practice Address - Zip Code:59255-0096
Practice Address - Country:US
Practice Address - Phone:406-768-6663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT246YC3302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246YC3302XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Physician Office Based