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General NPI Number Information
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NPI Number | 1023528031
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Entity Type | Individual
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Provider Name | RENI JOHNSON FNP
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Gender | Female
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Dates
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Enumeration Date | 10/04/2017
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Last Update Date | 03/23/2022
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Provider Practice Location Address
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Address Line | 425 OLD NEWMAN RD STE 402
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City | FRISCO
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State | TX
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Zip | 75036-8184
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Country | US
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Telephone | 972-499-5551
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Fax | 972-499-9150
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Provider Business Mailing Address
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Address Line | 5570 FM 423 STE 250 PMB#177
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City | FRISCO
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State | TX
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Zip | 75036-8929
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Country | US
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Telephone | 972-499-5551
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Fax | 972-499-9150
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP134872
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License Number State | TX
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