Provider Demographics
NPI:1982260550
Name:JOHNSON, JOSELLINE (ARNP)
Entity type:Individual
Prefix:MISS
First Name:JOSELLINE
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 160748
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32716-0748
Mailing Address - Country:US
Mailing Address - Phone:561-253-3980
Mailing Address - Fax:691-253-3985
Practice Address - Street 1:1630 S CONGRESS AVE STE 200
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2171
Practice Address - Country:US
Practice Address - Phone:561-253-3980
Practice Address - Fax:561-253-3985
Is Sole Proprietor?:No
Enumeration Date:2019-05-19
Last Update Date:2024-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11002459363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily