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NPI Code Detail

MEDICARE: LYNN COOPER JOHNSON FNP

MEDICARE: LYNN COOPER JOHNSON FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WE0003XEmergency Registered NurseRN168022AZ
2363LF0000XFamily Nurse PractitionerAP5735AZ
3363LP0808XPsychiatric/Mental Health Nurse PractitionerAP11496AZ

General Provider Information

NPI Number : 1124318159
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNN COOPER JOHNSON FNP
Provider Business Mailing Address
First Line : 5551 S WHITE MOUNTAIN RD UNIT 2
Second Line :
City : SHOW LOW
State : AZ
Zip : 85901-7449
Country : US
Telephone Number : 928-985-1495
Fax Number :
Provider Business Practice Location Address
First Line : 914 N SAN FRANCISCO ST STE D
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86001-3254
Country : US
Telephone Number : 928-243-0244
Fax Number : 928-597-5198
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2011
Last Update Date : 02/18/2020

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