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NPI 1154905008

NPI 1154905008 : ADRIANNE MARIE WARREN JOHNSON APRN : BOONEVILLE, KY

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General NPI Number Information
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    NPI Number           |    1154905008
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    Entity Type          |    Individual 
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    Provider Name        |    ADRIANNE MARIE WARREN JOHNSON APRN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/07/2021
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    Last Update Date     |    09/08/2022
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Provider Practice Location Address
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    Address Line         |    826 KY 11 N 
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    City                 |    BOONEVILLE
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    State                |    KY
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    Zip                  |    41314-9155
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    Country              |    US
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    Telephone            |    606-593-6395
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    Fax                  |    606-593-5916
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Provider Business Mailing Address
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    Address Line         |    1022 PIERSON ROAD 
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    City                 |    BOONEVILLE
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    State                |    KY
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    Zip                  |    41314
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    Country              |    US
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    Telephone            |    513-748-9948
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    Fax                  |    
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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        |    363LX0106X
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    Taxonomy Name        |    Occupational Health Nurse Practitioner
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    License Number       |    3015076
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    License Number State |    KY
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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       |    3015076
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    License Number State |    KY
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