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NPI Code Detail

MEDICARE: DR. DEORA KAYE JOHNSON DNP, CRNP

MEDICARE: DR. DEORA KAYE JOHNSON DNP, CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerR193679MD

General Provider Information

NPI Number : 1336139278
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEORA KAYE JOHNSON DNP, CRNP
Provider Business Mailing Address
First Line : 1 RESEARCH CT STE 450
Second Line :
City : ROCKVILLE
State : MD
Zip : 20850-6252
Country : US
Telephone Number : 240-428-3047
Fax Number : 888-815-3583
Provider Business Practice Location Address
First Line : 10 NORTH GREENE ST.
Second Line : 6D-104
City : BALTIMORE
State : MD
Zip : 21201-1524
Country : US
Telephone Number : 410-605-7363
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2005
Last Update Date : 04/13/2025

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