Individual
ELLEN A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6 PERRI AVENUE, MYERSTOWN, PA 17067-3200
(717) 949-6581
(717) 949-2070
Mailing address
PO BOX 300, 4TH & WILLOW STREET, LEBANON, PA 17042-0300
(171) 272-4451
(717) 272-4532
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD039460E
PA
207V00000X
Obstetrics & Gynecology Physician
MD039460E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001116065
—
PA
Enumeration date
07/11/2006
Last updated
06/24/2011
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