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General NPI Number Information
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NPI Number | 1750020178
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Entity Type | Individual
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Provider Name | KATHERYN JOHNSON NP-C
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Gender | Female
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Dates
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Enumeration Date | 06/02/2022
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 1950 DIAMOND PKWY
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City | KANSAS CITY
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State | MO
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Zip | 64116-4328
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Country | US
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Telephone | 816-852-3960
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Fax |
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Provider Business Mailing Address
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Address Line | 21120 W 226TH ST
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City | SPRING HILL
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State | KS
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Zip | 66083-3144
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Country | US
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Telephone |
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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 | 2022016438
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License Number State | MO
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