Individual
JOHNNIE HAMBY WAATAJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1918 RANDOLPH RD, CHARLOTTE, NC 28207-1100
(704) 384-9437
(704) 384-9440
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
101234
NC
Other
Enumeration date
04/10/2006
Last updated
08/29/2025
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