person
Mrs. Lisa Marie Johnson, PA
Medical Physician Assistant in Indialantic, Florida
NPI 1295877785

Lisa Marie Johnson is a Medical Physician Assistant based in Indialantic, FL and is specialized in Medical. Lisa Marie Johnson practices in Indialantic, FL and has the professional credentials of PA. The NPI Number for Lisa Marie Johnson is 1295877785 and holds a License No. 1338 (Florida).

The current practice location address for Lisa Marie Johnson is 150 5Th Ave Ste A, Indialantic, FL and can be reached out via phone at 321-254-6803 and via fax at 321-254-6819.

Location: 150 5Th Ave Ste A, Indialantic, FL, 32903-3154
person
Provider Profile Details
NPI Number
1295877785
Provider Name
Lisa Marie Johnson
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
150 5Th Ave Ste A, Indialantic, FL, 32903-3154
Phone Number
321-254-6803
Fax Number
321-254-6819
Provider Enumeration Date
02/13/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
200028010A 05 OK
institution
Provider Business Practice Location Address Details
Address
150 5Th Ave Ste A
City
State
Zip
32903-3154
Phone Number
321-254-6803
Fax Number
321-254-6819
person
Provider Business Mailing Address Details
Address
150 5Th Ave Ste A
City
State
Zip
32903-3154
Phone Number
321-254-6803
Fax Number
321-254-6819
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
1338 (Oklahoma)
Definition
Definition to come...
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