Healthcare Provider Details

I. General information

NPI: 1235711961
Provider Name (Legal Business Name): KAPRI JOHNSON DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 FORT HILL AVE
CANANDAIGUA NY
14424-1159
US

IV. Provider business mailing address

400 FORT HILL AVE
CANANDAIGUA NY
14424-1159
US

V. Phone/Fax

Practice location:
  • Phone: 585-393-7100
  • Fax:
Mailing address:
  • Phone: 585-393-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number776116
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number407889
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: