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General NPI Number Information
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NPI Number | 1982030276
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Entity Type | Individual
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Provider Name | CORLINA M JOHNSON AGPCNP-BC, AAHIVS
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Gender | Female
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Dates
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Enumeration Date | 09/19/2013
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 1501 CORPORATE DR STE 100-S6
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-6600
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Country | US
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Telephone | 561-250-3595
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Fax | 561-783-2207
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Provider Business Mailing Address
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Address Line | 1501 CORPORATE DR STE 100-S6
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-6600
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Country | US
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Telephone | 561-250-3595
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Fax | 561-783-2207
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 9274792
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | ARNP9274792
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | ARNP9274792
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | ARNP9274792
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License Number State | FL
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