Most Relevant Information
Provider Data
| NPI Number: | 1003250101 |
| Provider Name: | TYREASEA ANICHA JOHNSON-MASON NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | SP012833 |
Most Important Dates
| Enumeration Date: | 04/19/2013 |
| Last Updated: | 04/15/2020 |
Provider Practice Location
215 HIGHLAND AVE STE 100
HADDON TOWNSHIP
NJ
081082634
Practice Location Phone/Fax
| Phone: | 6093504792 |
| Fax: | 8568231922 |
Provider Mailing Location
215 HIGHLAND AVE STE 100
HADDON TOWNSHIP
NJ
081082634
Provider Mailing Phone/Fax
| Phone: | 6093504792 |
| Fax: | 8568231922 |