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General NPI Number Information
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NPI Number | 1629564182
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Entity Type | Individual
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Provider Name | ALLYSSA CHRISTINE JOHNSON APRN, FNP, AGACNP
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Gender | Female
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Dates
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Enumeration Date | 07/09/2018
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 204 W 19TH ST STE 200
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City | HOUSTON
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State | TX
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Zip | 77008-4077
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Country | US
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Telephone | 281-318-1122
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Fax | 281-946-5564
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Provider Business Mailing Address
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Address Line | 1642 RICHELIEU LN
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City | HOUSTON
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State | TX
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Zip | 77018-1835
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Country | US
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Telephone | 817-437-7926
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP137789
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License Number State | TX
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