Mrs Raeanne Tatem Johnson, RN,MSN,CPNP-PC - Pediatrics in Knightdale, NC

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Mrs Raeanne Tatem Johnson, RN,MSN,CPNP-PC is a Pediatrics - Developmental - Behavioral Pediatrics based in Knightdale, North Carolina. Mrs Raeanne Tatem Johnson is licensed to practice in North Carolina (license number 20227375) and her current practice location is 1005 Big Oak Ct, Knightdale, North Carolina. She can be reached at her office (for appointments etc.) via phone at (919) 266-5669.

NPI number for Mrs Raeanne Tatem Johnson is 1245639830 and her current mailing address is 260 Horizon Dr, Raleigh, North Carolina. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1245639830.

Contact Information

Mrs Raeanne Tatem Johnson, RN,MSN,CPNP-PC
1005 Big Oak Ct,
Knightdale, NC 27545-6565
(919) 266-5669
(919) 488-1717

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Provider's Profile

Full NameMrs Raeanne Tatem Johnson
GenderFemale
SpecialityPediatrics - Developmental - Behavioral Pediatrics
Location1005 Big Oak Ct, Knightdale, North Carolina
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1245639830
  • Provider Enumeration Date: 08/19/2014
  • Last Update Date: 07/11/2022

Medical Identifiers

Medical identifiers for Mrs Raeanne Tatem Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1245639830NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0200XNurse Practitioner - Pediatrics 5007103 (North Carolina)Secondary
2080P0006XPediatrics - Developmental - Behavioral Pediatrics 20227375 (North Carolina)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Raeanne Tatem Johnson is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Raeanne Tatem Johnson, RN,MSN,CPNP-PC
260 Horizon Dr,
Raleigh, NC 27615-4922

Ph: (919) 488-0015		Mrs Raeanne Tatem Johnson, RN,MSN,CPNP-PC
1005 Big Oak Ct,
Knightdale, NC 27545-6565

Ph: (919) 266-5669

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