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Individual

CYNTHIA ANN JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
111 N HOFFMAN ST, DALLAS, NC 28034-1597
(704) 470-7092
(949) 864-3002
Mailing address
818 PARKWOOD RD, SHELBY, NC 28150-5535
(704) 470-7092
(949) 864-3002

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5005395
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1932483252
NC
01
NC4006C
MEDICARE PTAN
NC
01
NP3419
MEDICARE PTAN
SC
05
SCP3714292
SC
Enumeration date
10/05/2011
Last updated
08/24/2025
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