Healthcare Provider Details

I. General information

NPI: 1265356653
Provider Name (Legal Business Name): AIMEE KATHLEEN JOHNSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1508 W CANNON AVE
ARTESIA NM
88210
US

IV. Provider business mailing address

197 S ESPUELA RD
LAKE ARTHUR NM
88253-9766
US

V. Phone/Fax

Practice location:
  • Phone: 575-691-6853
  • Fax:
Mailing address:
  • Phone: 575-691-6853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number441352
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: