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General NPI Number Information
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NPI Number | 1982060497
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Entity Type | Individual
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Provider Name | LISA JOHNSON FNP-C, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/13/2016
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 4701 SANGAMORE RD STE N100
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City | BETHESDA
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State | MD
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Zip | 20816-2558
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Country | US
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Telephone | 301-985-2898
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Fax | 301-985-9820
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Provider Business Mailing Address
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Address Line | 4701 SANGAMORE RD STE N100
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City | BETHESDA
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State | MD
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Zip | 20816-2558
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Country | US
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Telephone | 301-985-2898
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Fax | 301-985-2890
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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 | R185905
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License Number State | MD
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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 | R185905
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | LG-0001237
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License Number State | DE
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | L8-0010330
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License Number State | DE
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN1015708
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License Number State | DC
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Taxonomy #6
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R185905
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License Number State | MD
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