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General NPI Number Information
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NPI Number | 1912951005
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Entity Type | Individual
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Provider Name | ANGELA JOHNSON FNP
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Gender | Female
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 438 E VANN RD SUITE 202
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City | GREENEVILLE
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State | TN
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Zip | 37743-7202
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Country | US
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Telephone | 423-278-1712
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Fax | 423-278-1703
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Provider Business Mailing Address
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Address Line | PO BOX 37087
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City | BALTIMORE
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State | MD
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Zip | 21297-3087
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Country | US
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Telephone | 828-687-5616
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Fax | 828-650-8076
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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 | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | RD100377
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License Number State | TN
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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 | APN6998
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License Number State | TN
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