Individual
HEATHER K. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
725 ALBANY ST, SHAPIRO 8, SUITE A, BOSTON, MA 02118-2526
(617) 638-8419
(617) 414-0201
Mailing address
720 HARRISON AVE STE 9600, DOB SUITE 9600, BOSTON, MA 02118-2343
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA4264
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110109529A
—
MA
Enumeration date
02/21/2012
Last updated
09/28/2017
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