Provider Demographics
NPI:1548295041
Name:JOHNS, FRANCINE E (PA-C)
Entity type:Individual
Prefix:
First Name:FRANCINE
Middle Name:E
Last Name:JOHNS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:FRANCINE
Other - Middle Name:E
Other - Last Name:LUCIBELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5783 WOOSTER PIKE
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8816
Mailing Address - Country:US
Mailing Address - Phone:330-725-0569
Mailing Address - Fax:330-662-0258
Practice Address - Street 1:5783 WOOSTER PIKE
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8816
Practice Address - Country:US
Practice Address - Phone:330-725-0569
Practice Address - Fax:330-662-0258
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2020-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.001495RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0325313Medicaid