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Individual
COURTNEY PARHAM JOHNSON
Active
Individual
COURTNEY PARHAM JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006117
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1618655
AMERIGROUP
GA
01
—
685703
WELLCARE
GA
05
—
MC#003112617A&B
—
GA
Enumeration date
06/30/2011
Last updated
03/13/2015
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