Individual
MS. MARYELLEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
117 HAWLEY ST, BINGHAMTON, NY 13901-3903
(607) 723-8306
(607) 723-4087
Mailing address
117 HAWLEY ST, BINGHAMTON, NY 13901-3903
(607) 723-8306
(607) 723-4087
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
F360105-1
NY
367A00000X
Advanced Practice Midwife
203483-1
NY
367A00000X
Advanced Practice Midwife
MW010128
PA
Other
Enumeration date
07/19/2006
Last updated
02/23/2016
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