Individual
MR. DIRK A JOHNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
10 BROOKSIDE DR, LONGMEADOW, MA 01106-2318
(413) 531-7078
(413) 531-7078
Mailing address
10 BROOKSIDE DR, LONGMEADOW, MA 01106-2318
(508) 795-1555
(508) 755-4464
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9434
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1600371
—
MA
01
—
Y39849
BLUE CROSS BLUE SHIELD
MA
Enumeration date
03/01/2007
Last updated
05/27/2021
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