| Mobile Fnp Jr Johnson Pllc | |
|
236 N Mebane St Ste 123 Burlington NC 27217-3900 | |
| (336) 639-7149 | |
| (336) 639-7141 |
| Full Name | Mobile Fnp Jr Johnson Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 236 N Mebane St Ste 123, Burlington, North Carolina |
| Authorized Official Name and Position | Julie Randolph Johnson (OWNER) |
| Authorized Official Contact | 3366397149 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile Fnp Jr Johnson Pllc 821 Brooks Rd Reidsville NC 27320-7579 Ph: (336) 639-7149 | Mobile Fnp Jr Johnson Pllc 236 N Mebane St Ste 123 Burlington NC 27217-3900 Ph: (336) 639-7149 |
| NPI Number | 1194382945 |
|---|---|
| Provider Enumeration Date | 05/28/2019 |
| Last Update Date | 10/31/2023 |
| Certification Date | 10/31/2023 |
| Medicare PECOS PAC ID | 4880013986 |
|---|---|
| Medicare Enrollment ID | O20200923000358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194382945 | NPI | - | NPPES |
| 1013300383 | Medicaid | NC | |
| 1194382945 | Medicaid | NC |
| Provider Name | Julie R Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013300383 PECOS PAC ID: 7315211125 Enrollment ID: I20170918002211 |
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