Provider Demographics
NPI:1316433915
Name:VONHAGN, JOHANNA SOFIA (PA-C)
Entity type:Individual
Prefix:
First Name:JOHANNA
Middle Name:SOFIA
Last Name:VONHAGN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:2327 HANOVER PIKE
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-1150
Mailing Address - Country:US
Mailing Address - Phone:443-507-6035
Mailing Address - Fax:443-507-6953
Practice Address - Street 1:2327 HANOVER PIKE
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:MD
Practice Address - Zip Code:21074-1150
Practice Address - Country:US
Practice Address - Phone:443-507-6035
Practice Address - Fax:443-507-6953
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2024-04-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant