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General NPI Number Information
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NPI Number | 1174525091
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Entity Type | Individual
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Provider Name | CARRIE LYNN JOHNSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 1138 COUNTRY CLUB BLVD
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City | CAPE CORAL
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State | FL
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Zip | 33990-3027
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Country | US
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Telephone | 239-424-1900
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Fax | 239-424-1904
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Provider Business Mailing Address
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Address Line | PO BOX 2147
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City | FORT MYERS
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State | FL
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Zip | 33902-2147
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Country | US
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Telephone | 239-424-1900
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Fax | 239-424-1904
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD189072
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD61550112
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME102875
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036090783
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License Number State | IL
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