Healthcare Provider Details

I. General information

NPI: 1639775729
Provider Name (Legal Business Name): DENISE N JOHNSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2020
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 S THOMPSON AVE
SPRINGFIELD OH
45506-1145
US

IV. Provider business mailing address

326 S THOMPSON AVE
SPRINGFIELD OH
45506-1145
US

V. Phone/Fax

Practice location:
  • Phone: 800-829-5461
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0027793
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.347213
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: