MEDICARE: ERICA L JOHNSON PMHNP-BC

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
1	163W00000X	Registered Nurse	RN270058	OH
2	163W00000X	Registered Nurse	61151126	WA
3	163W00000X	Registered Nurse	256698-30	WI
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	61151704	WA
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP026168	OH
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN-CNP026168	OH
7	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	10456-33	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336395706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA L JOHNSON PMHNP-BC

Provider Business Mailing Address
First Line	:	1125 W WOODRUFF AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-4853
Country	:	US
Telephone Number	:	419-309-2659
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 E STATE ST
Second Line	:
City	:	ATHENS
State	:	OH
Zip	:	45701-1856
Country	:	US
Telephone Number	:	614-743-4640
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2008
Last Update Date	:	05/14/2025

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