Individual
MS. CHRISTINA ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
221 W MAPLE AVE, FAYETTEVILLE, WV 25840
(304) 574-3960
(304) 574-2179
Mailing address
PO BOX 337, SCARBRO, WV 25917-0337
(304) 469-2905
(304) 465-5486
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
00741
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810000503
—
WV
Enumeration date
08/26/2005
Last updated
01/17/2019
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