NPI Code Details Logo

NPI 1639775729

NPI 1639775729 : DENISE N JOHNSON NP : DAYTON, OH

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1639775729
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    DENISE N JOHNSON NP
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    12/05/2020
-----------------------------------------------------
    Last Update Date     |    01/21/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    5464 BURKHARDT RD 
-----------------------------------------------------
    City                 |    DAYTON
-----------------------------------------------------
    State                |    OH
-----------------------------------------------------
    Zip                  |    45431-2112
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    833-510-4357
-----------------------------------------------------
    Fax                  |    866-460-2997
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    4600 MONTGOMERY RD STE 400 
-----------------------------------------------------
    City                 |    CINCINNATI
-----------------------------------------------------
    State                |    OH
-----------------------------------------------------
    Zip                  |    45212-2600
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    833-510-4357
-----------------------------------------------------
    Fax                  |    866-460-2997
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363LF0000X
-----------------------------------------------------
    Taxonomy Name        |    Family Nurse Practitioner
-----------------------------------------------------
    License Number       |    APRN.CNP.0027793
-----------------------------------------------------
    License Number State |    OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    163W00000X
-----------------------------------------------------
    Taxonomy Name        |    Registered Nurse
-----------------------------------------------------
    License Number       |    RN.347213
-----------------------------------------------------
    License Number State |    OH
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.