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Contact Information

CHRISTINA A JOHNSON, PAC
221 W MAPLE AVE
FAYETTEVILLE, WV25840
 Phone: 304-574-3960
 Fax: 304-574-2179
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for CHRISTINA A JOHNSON · (Female)

NPI Number 1366435166
Status Active
Credentials PAC
Entity Individual
Enumeration date 08/26/2005
Last updated 01/17/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • WV License # 00741
  • WV Medicaid 3810000503
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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