Provider Demographics
NPI:1316720410
Name:JOHNSON, ALANA FAITH
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:FAITH
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 COMPASS POINT DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:MA
Mailing Address - Zip Code:01516-0616
Mailing Address - Country:US
Mailing Address - Phone:774-666-0138
Mailing Address - Fax:
Practice Address - Street 1:68 COMPASS POINT DR
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:MA
Practice Address - Zip Code:01516-0616
Practice Address - Country:US
Practice Address - Phone:774-666-0138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program