Provider Demographics
NPI:1932097789
Name:JOHNSON, MEGHAN ANGELA (CMA)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ANGELA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CMA
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:ANGELA
Other - Last Name:AZORLIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:524 N 19TH ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4711
Mailing Address - Country:US
Mailing Address - Phone:701-989-1118
Mailing Address - Fax:
Practice Address - Street 1:524 N 19TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4711
Practice Address - Country:US
Practice Address - Phone:701-989-1118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant