Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Stephanie Johnson, PA

Individual provider Physician Assistant · NPI 1104135052

Stephanie Johnson, PA is a Physician Assistant in Liverpool, New York. Licensed in Arizona, Florida and New York. Registered with an NPI since 2010.

Licensed in
AZ, FL, NY
In the registry since
2010
Specialties on file
3
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

5046 Betsy Ross Way
Liverpool, NY 13088-5933
Phone: (315) 956-0900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 014259 (NY)
Physician Assistant Taxonomy 363A00000X · Licence 4777 (AZ)
Physician Assistant Taxonomy 363A00000X · Licence 9108630 (FL)

Record details

NPI number1104135052
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 27, 2010
Last updated in NPPESJuly 6, 2021
Certification dateJuly 6, 2021
Mailing address5046 Betsy Ross Way, Liverpool, NY 13088-5933

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