Healthcare Provider Details

I. General information

NPI: 1033060462
Provider Name (Legal Business Name): KATHERINE JOHNSON CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2026
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 COMMERCE WAY
LIBBY MT
59923-3002
US

IV. Provider business mailing address

225 COMMERCE WAY
LIBBY MT
59923-3002
US

V. Phone/Fax

Practice location:
  • Phone: 406-293-2721
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number8771895
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License NumberNUR-RN-LIC-174252
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: