Individual
ASHLEY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
101 S PLUM ST, VERMILLION, SD 57069-3306
(605) 624-8643
Mailing address
1104 W 8TH ST, YANKTON, SD 57078-3306
(605) 665-7841
(605) 665-8337
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1106
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1106
MEDICAL LICENSE
SD
01
—
1145505
NCCPA CERTIFICATION
—
Enumeration date
09/08/2017
Last updated
05/22/2024
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