Individual
WANDA E. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2300 PATTERSON ST, NASHVILLE, TN 37203-1538
(615) 342-1000
Mailing address
PO BOX 634811, CINCINNATI, OH 45263-4811
(865) 292-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA584
TN
363A00000X
Physician Assistant
TN584
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3669802
—
TN
01
—
4068754
BLUECROSS
TN
Enumeration date
06/09/2006
Last updated
02/23/2025
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