Individual
DR. JEANETTE R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
6 REGIONAL CR, SUITE A, PINEHURST, NC 28374
(910) 295-9255
(910) 295-7255
Mailing address
6 REGIONAL CR, SUITE A, PINEHURST, NC 28374
(910) 295-9255
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
531
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
65554
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
06/27/2005
Last updated
09/09/2011
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