Individual
IDELLA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1610 TAZEWELL RD, SUITE 201, TAZEWELL, TN 37879-3600
(423) 626-8393
(423) 626-8749
Mailing address
1610 TAZEWELL RD, SUITE 201, TAZEWELL, TN 37879-3600
(423) 626-8393
(423) 626-8749
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
670
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3669471
—
TN
01
—
4058153
BCBS OF TENNESSEE
TN
Enumeration date
06/08/2006
Last updated
12/16/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us