MEDICARE: LINDSEY ALLYSON JOHNSON FNP-C

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	363LF0000X	Family Nurse Practitioner	C-APN.0105715-C-NP	CO
2	363LF0000X	Family Nurse Practitioner	RN178235	AZ
3	363LF0000X	Family Nurse Practitioner	APRN-5707	HI

General Provider Information

NPI Number	:	1558083964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY ALLYSON JOHNSON FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 211699
Second Line	:
City	:	EAGAN
State	:	MN
Zip	:	55121-3699
Country	:	US
Telephone Number	:	866-849-0692
Fax Number	:	888-973-8821

Provider Business Practice Location Address
First Line	:	3623 CROSSINGS DR STE 206
Second Line	:
City	:	PRESCOTT
State	:	AZ
Zip	:	86305-7101
Country	:	US
Telephone Number	:	866-849-0692
Fax Number	:	888-973-8821

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

Provider Enumeration Date	:	09/13/2022
Last Update Date	:	02/20/2026

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