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General NPI Number Information
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NPI Number | 1083993273
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Entity Type | Individual
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Provider Name | MOIS A JOHNSON NP
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Gender | Female
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Dates
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Enumeration Date | 08/05/2011
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 203 W MAIN ST
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City | FARMINGTON
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State | NM
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Zip | 87401-6244
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Country | US
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Telephone | 505-517-4181
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Fax | 505-333-0444
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Provider Business Mailing Address
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Address Line | 2301 E 20TH ST UNIT 6687
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City | FARMINGTON
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State | NM
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Zip | 87499-7231
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Country | US
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Telephone | 505-800-7335
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Fax | 505-333-0444
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209000639
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53658
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 27001480
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | C-APN.0002620-C-NP
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License Number State | CO
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 277001480
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | C-APN.002320-C-NP
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License Number State | CO
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Taxonomy #7
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 53658
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License Number State | NM
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