Individual
HANNAH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4359 NEW SHEPHERDSVILLE RD UNIT 245, BARDSTOWN, KY 40004-8004
(502) 350-5492
(502) 350-5822
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7835
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA2044
KY
363AS0400X
Surgical Physician Assistant
TC438
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100386810
—
KY
Enumeration date
10/13/2015
Last updated
02/09/2022
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