Provider Demographics
NPI:1972980324
Name:JOHNSON, BRITTANY EVELYN (CP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:EVELYN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:123 PROFESSIONAL PARK DR
Mailing Address - Street 2:STE 100
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-5524
Mailing Address - Country:US
Mailing Address - Phone:704-799-9825
Mailing Address - Fax:704-799-9826
Practice Address - Street 1:123 PROFESSIONAL PARK DR
Practice Address - Street 2:STE 100
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-5524
Practice Address - Country:US
Practice Address - Phone:704-799-9825
Practice Address - Fax:704-799-9826
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist