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1124564083 NPI number — MEREDITH N. JOHNSON APRN

NPI Number: 1124564083
Health Care Provider/Practitioner: MEREDITH N. JOHNSON APRN

Information about “1124564083” NPI (MEREDITH N. JOHNSON APRN) exists in 1124564083 in HTML format HTML  |  1124564083 in plain Text format TXT  |  1124564083 in PDF (Portable Document Format) PDF  |  1124564083 in an XML format XML  formats.

NPI Number : 1124564083 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124564083",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JOHNSON",
    "FirstName": "MEREDITH",
    "MiddleName": "N.",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "APRN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BASHAM",
    "OtherFirstName": "MEREDITH",
    "OtherMiddleName": "N.",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "APRN",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 932958",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CLEVELAND",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "44193-0028",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "502-873-1260",
    "MailingAddressFaxNumber": "502-873-1261",
    "FirstLinePracticeLocationAddress": "9080 TAYLORSVILLE RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LOUISVILLE",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "40299-1750",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "502-491-8805",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/16/2017",
    "LastUpdateDate": "07/01/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "28197992A",
          "LicenseNumberStateCode": "IN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "3012674",
          "LicenseNumberStateCode": "KY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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