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General NPI Number Information
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NPI Number | 1730781451
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Entity Type | Individual
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Provider Name | KARL ALAN JOHNSON FNP-C
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Gender | Male
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Dates
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Enumeration Date | 11/09/2020
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 1551 S SECOND ST
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City | GALLUP
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State | NM
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Zip | 87301-5881
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Country | US
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Telephone | 505-542-0090
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Fax | 505-542-0155
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Provider Business Mailing Address
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Address Line | 1551 S SECOND ST
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City | GALLUP
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State | NM
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Zip | 87301-5881
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Country | US
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Telephone | 505-542-0090
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Fax | 505-542-0155
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11032336-4405
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1093694
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 80531
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License Number State | NM
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