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NPI Code Detail

MEDICARE: STACY JOHNSON APRN-CNP

MEDICARE:   STACY  JOHNSON  APRN-CNP
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
1163W00000XRegistered Nurse606779TX
2363LF0000XFamily Nurse PractitionerAP135193TX

General Provider Information

NPI Number : 1215452578
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY JOHNSON APRN-CNP
Provider Business Mailing Address
First Line : 540 CHAPEL DR
Second Line :
City : MEXIA
State : TX
Zip : 76667-3490
Country : US
Telephone Number : 254-562-2821
Fax Number : 254-562-1183
Provider Business Practice Location Address
First Line : 540 CHAPEL DR
Second Line :
City : MEXIA
State : TX
Zip : 76667-3490
Country : US
Telephone Number : 254-562-2821
Fax Number : 254-562-1183
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2017
Last Update Date : 05/02/2025

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Directions to “ STACY JOHNSON APRN-CNP” Practice Location

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