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NPI Code Detail

MEDICARE: DENISE JOHNSON CRNP

MEDICARE: DENISE JOHNSON CRNP
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
1363LF0000XFamily Nurse Practitioner1134759AL

General Provider Information

NPI Number : 1407242795
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE JOHNSON CRNP
Provider Business Mailing Address
First Line : 645 WYNN DR NW UNIT 5892
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35814-6038
Country : US
Telephone Number : 347-683-8141
Fax Number : 866-445-6383
Provider Business Practice Location Address
First Line : 4200 CHRIS DR SW
Second Line : #100
City : HUNTSVILLE
State : AL
Zip : 35802-4197
Country : US
Telephone Number : 256-880-1101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2015
Last Update Date : 05/21/2019

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