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NPI Code Detail

MEDICARE: JEANNIE JOHNSON FNP-C

MEDICARE:   JEANNIE  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
1363LF0000XFamily Nurse PractitionerAP136472TX

General Provider Information

NPI Number : 1558861971
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANNIE JOHNSON FNP-C
Provider Business Mailing Address
First Line : 1603 TALLOWOOD LN
Second Line :
City : NEDERLAND
State : TX
Zip : 77627-4655
Country : US
Telephone Number : 409-960-1077
Fax Number :
Provider Business Practice Location Address
First Line : 1509 S HIGHWAY 69
Second Line :
City : NEDERLAND
State : TX
Zip : 77627-7807
Country : US
Telephone Number : 409-722-9355
Fax Number : 409-420-1002
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2018
Last Update Date : 08/24/2019

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Directions to “ JEANNIE JOHNSON FNP-C” Practice Location

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