Healthcare Provider Details

I. General information

NPI: 1477925568
Provider Name (Legal Business Name): CRYSTAL JOHNSON PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2015
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 COOL SPRINGS BLVD STE 140
FRANKLIN TN
37067-7222
US

IV. Provider business mailing address

220 ATHENS WAY STE 104
NASHVILLE TN
37228-1351
US

V. Phone/Fax

Practice location:
  • Phone: 615-320-1155
  • Fax: 615-320-1177
Mailing address:
  • Phone: 615-320-1155
  • Fax: 615-320-1177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number20622
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number20622
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20622
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: