Healthcare Provider Details

I. General information

NPI: 1235575788
Provider Name (Legal Business Name): ADRIENNE JANE JOHNSON ANP,FNP-BC,APRN, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ADRIENNE JANE DAHLGREN

II. Dates (important events)

Enumeration Date: 05/10/2013
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 AIRPORT HEIGHTS DR STE 240
ANCHORAGE AK
99508-2970
US

IV. Provider business mailing address

5598 KENAI FJORDS LOOP
ANCHORAGE AK
99502-4047
US

V. Phone/Fax

Practice location:
  • Phone: 907-290-4666
  • Fax: 907-921-5151
Mailing address:
  • Phone: 907-952-2296
  • Fax: 907-921-5151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1359
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: