Most Relevant Information
Provider Data
| NPI Number: | 1003067984 |
| Provider Name: | ANNIE JOHNSON PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | PA-777 |
Most Important Dates
| Enumeration Date: | 10/09/2008 |
| Last Updated: | 12/01/2010 |
Provider Practice Location
708 E WYTHE CREEK CT STE 103
KUNA
ID
836345005
Practice Location Phone/Fax
| Phone: | 2089225130 |
| Fax: | 2089225132 |
Provider Mailing Location
PO BOX 68
KUNA
ID
836340068
Provider Mailing Phone/Fax
| Phone: | 2089225130 |
| Fax: | 2089225132 |