Individual
FIONA DEBRA JOHANSMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
103 PROVIDENCE HWY, EAST WALPOLE, MA 02032-1512
(781) 255-0500
Mailing address
103 PROVIDENCE HWY, EAST WALPOLE, MA 02032-1512
(781) 255-0500
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA6181
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA6181
LICENSE NUMBER
MA
Enumeration date
09/14/2017
Last updated
07/12/2022
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