Individual
TIARA ALIVIA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1645 N GERMANTOWN PKWY, CORDOVA, TN 38016-5962
(901) 825-5360
(901) 825-5361
Mailing address
1645 N GERMANTOWN PKWY, CORDOVA, TN 38016-5962
(901) 825-5360
(901) 825-5361
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
Primary
6859
TN
Other
Enumeration date
06/17/2025
Last updated
01/21/2026
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