Provider Demographics
NPI:1336717610
Name:JOHNSON, CAYLOR ASHLEY (CRNP)
Entity Type:Individual
Prefix:MS
First Name:CAYLOR
Middle Name:ASHLEY
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 N WASHINGTON ST APT 2
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1020
Mailing Address - Country:US
Mailing Address - Phone:610-608-0925
Mailing Address - Fax:
Practice Address - Street 1:145 N NARBERTH AVE
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-1963
Practice Address - Country:US
Practice Address - Phone:610-628-1854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023874363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily