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NPI Code Detail

MEDICARE: KATHERYN JOHNSON NP-C

MEDICARE: KATHERYN JOHNSON NP-C
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
1363LF0000XFamily Nurse Practitioner2022016438MO

General Provider Information

NPI Number : 1750020178
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERYN JOHNSON NP-C
Provider Business Mailing Address
First Line : 21120 W 226TH ST
Second Line :
City : SPRING HILL
State : KS
Zip : 66083-3144
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1950 DIAMOND PKWY
Second Line :
City : KANSAS CITY
State : MO
Zip : 64116-4328
Country : US
Telephone Number : 816-852-3960
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2022
Last Update Date : 11/06/2024

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