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NPI Code Detail

MEDICARE: MS. KERIANNE EVANS JOHNSON APN CNP

MEDICARE:  MS. KERIANNE EVANS JOHNSON  APN CNP
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
1363L00000XNurse Practitioner209005205IL

General Provider Information

NPI Number : 1740333483
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KERIANNE EVANS JOHNSON APN CNP
Provider Business Mailing Address
First Line : 1000 E WASHINGTON
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62703
Country : US
Telephone Number : 217-544-2744
Fax Number : 217-544-2746
Provider Business Practice Location Address
First Line : 18 S MICHIGAN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60603-3200
Country : US
Telephone Number : 312-592-6800
Fax Number : 312-592-6801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2007
Last Update Date : 12/07/2011

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Directions to “ MS. KERIANNE EVANS JOHNSON APN CNP” Practice Location

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