Provider Demographics
NPI:1285269852
Name:CAMEO JOHNSON NP, PLLC
Entity type:Organization
Organization Name:CAMEO JOHNSON NP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAMEO
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:928-243-0244
Mailing Address - Street 1:2030 W BASELINE RD # 182-8355
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-6574
Mailing Address - Country:US
Mailing Address - Phone:928-235-2927
Mailing Address - Fax:928-268-0289
Practice Address - Street 1:2030 W BASELINE RD # 182-8355
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-6574
Practice Address - Country:US
Practice Address - Phone:928-235-2927
Practice Address - Fax:928-268-0289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty