Provider Demographics
NPI:1326458530
Name:AYERS-JOHNSON, MARGARET ELLEN (PA)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ELLEN
Last Name:AYERS-JOHNSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 CLIFF RD E
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-1545
Mailing Address - Country:US
Mailing Address - Phone:952-697-1848
Mailing Address - Fax:
Practice Address - Street 1:755 CLIFF RD E
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-1545
Practice Address - Country:US
Practice Address - Phone:952-697-1848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2024-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA174348363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant