Provider Demographics
NPI:1871181594
Name:JOHNSON, CATHERINE (PCA)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 MILL ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-1804
Mailing Address - Country:US
Mailing Address - Phone:609-518-2494
Mailing Address - Fax:609-518-2495
Practice Address - Street 1:34 MILL ST
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NJ
Practice Address - Zip Code:08060-1804
Practice Address - Country:US
Practice Address - Phone:609-518-2494
Practice Address - Fax:609-518-2495
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NH01123900374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide