person
Brett Johansen, PA-C
Medical Physician Assistant in Fruitland, Idaho
NPI 1982074696

Brett Johansen is a Medical Physician Assistant based in Fruitland, ID and is specialized in Medical. Brett Johansen practices in Fruitland, ID and has the professional credentials of PA-C. The NPI Number for Brett Johansen is 1982074696 and holds a License No. PA-1308 (Idaho).

The current practice location address for Brett Johansen is 1210 Nw 16Th St, Fruitland, ID and can be reached out via phone at 208-452-9881.

Location: 1210 Nw 16Th St, Fruitland, ID, 83619-2202
person
Provider Profile Details
NPI Number
1982074696
Provider Name
Brett Johansen
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
1210 Nw 16Th St, Fruitland, ID, 83619-2202
Phone Number
208-452-9881
Fax Number
Provider Enumeration Date
10/07/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1210 Nw 16Th St
City
State
Zip
83619-2202
Phone Number
208-452-9881
Fax Number
person
Provider Business Mailing Address Details
Address
1210 Nw 16Th St
City
State
Zip
83619-2202
Phone Number
208-452-9881
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA-1308 (Idaho)
Definition
Definition to come...
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