Basic Information
| Provider Information | |||||||||
| NPI: | 1982062758 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOLES-JOHNSON | ||||||||
| FirstName: | TEAH | ||||||||
| MiddleName: | NAKESHA SHANTE' | ||||||||
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| Credential: | AGNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1933 NORTHROP DR | ||||||||
| Address2: | |||||||||
| City: | WHITSETT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273779142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3366038485 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1814 WESTCHESTER DR | ||||||||
| Address2: | STE 301 | ||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272627299 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368022025 | ||||||||
| FaxNumber: | 3368022026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2016 | ||||||||
| LastUpdateDate: | 03/09/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 5008340 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.