Individual
THELMA ELAINE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN.,RNFA
Contact information
Practice address
2201 45TH ST, COLUMBIA HOSPITAL, WEST PALM BEACH, FL 33407-2047
(561) 863-3855
(561) 881-5474
Mailing address
849 UNIVERSITY BLVD, #205, JUPITER, FL 33458-3079
(561) 630-4467
(561) 630-4467
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
RN1475272
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y6109
BLUE CROSS BLUESHIELD
FL
Enumeration date
02/27/2007
Last updated
07/08/2007
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