Individual
MRS. TIFFANY SHEARN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
300 BETHESDA DR, GREENVILLE, NC 27834-7218
(252) 752-7141
Mailing address
300 BETHESDA DR, GREENVILLE, NC 27834-7218
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-00276
NC
Other
Enumeration date
06/05/2006
Last updated
07/16/2014
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