Johnson, Evelyn

Johnson, Evelyn is an individual health care provider with primary practice located at 542 4Th Ave Ste. 234, Fairbanks AK 99701-4714. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Johnson, Evelyn can be contacted via phone (907) 456-4524.

Contact Information

Primary practice address
542 4Th Ave Ste. 234 Fairbanks AK 99701-4714
Phone: (907) 456-4524
Fax: (907) 456-5524
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X 272340 Alaska

Profile Details

NPI number 1265565311
LBN Legal business name Johnson, Evelyn
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2007
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265565311 NPPES
Alaska MEDICAID CM4322

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