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General NPI Number Information
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NPI Number | 1760730576
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Entity Type | Individual
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Provider Name | MEGAN M JOHNSON NP
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Gender | Female
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Dates
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Enumeration Date | 08/28/2012
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 205 CADILLAC CT STE 6
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City | BELVIDERE
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State | IL
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Zip | 61008-1733
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Country | US
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Telephone | 815-494-8459
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Fax |
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Provider Business Mailing Address
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Address Line | 1976 SHAW WOODS DR
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City | ROCKFORD
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State | IL
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Zip | 61107-1730
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041266536
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 277004235
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License Number State | IL
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