Healthcare Provider Details

I. General information

NPI: 1801402631
Provider Name (Legal Business Name): DANIEL PATRICK JOHNSON APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2020
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 E ANDREW JOHNSON HWY
GREENEVILLE TN
37745-4375
US

IV. Provider business mailing address

1810 SINKING SPRINGS RD
MIDWAY TN
37809-5003
US

V. Phone/Fax

Practice location:
  • Phone: 423-620-1473
  • Fax: 386-588-5248
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberAP0000028116
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberAP0000028116
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP0000028116
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: