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General NPI Number Information
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NPI Number | 1831604834
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Entity Type | Individual
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Provider Name | ROBIN LOUISE JOHNSON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/12/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 200 SPUR 113
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City | TEAGUE
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State | TX
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Zip | 75860-5174
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Country | US
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Telephone | 254-739-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 149 PRIVATE ROAD 8422
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City | PALESTINE
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State | TX
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Zip | 75803-2799
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Country | US
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Telephone | 903-723-5593
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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 | 247718
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License Number State | TX
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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 | AP134959
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License Number State | TX
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