Individual
KADDIJATOU SANYANG JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MMS
Contact information
Practice address
10208 CERNY ST STE 110, RALEIGH, NC 27617-7885
(984) 215-4590
(984) 215-4591
Mailing address
5221 PARAMOUNT PKWY STE 220, MORRISVILLE, NC 27560-5490
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-05462
NC
Other
Enumeration date
01/05/2015
Last updated
09/15/2023
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