Individual
ELLEN I JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
420 HOLMES ST, BELLEFONTE, PA 16823-1401
(814) 355-6782
(814) 355-6985
Mailing address
420 HOLMES ST, BELLEFONTE, PA 16823-1401
(814) 355-6782
(814) 355-6985
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD039807E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010965340003
—
PA
01
—
100740
COMMUNITY CARE BEHAVIORAL HEALTH
PA
01
—
80118
HIGHMARK BLUE SHIELD
PA
01
—
A334449A
EMPIRE BLUE CROSS BLUE SHIELD
PA
Enumeration date
09/15/2006
Last updated
03/11/2010
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