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NPI Code Detail

MEDICARE: MR. ADRIAN TAKEYAMA JOHNSON APRN-CNP

MEDICARE: MR. ADRIAN TAKEYAMA 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
1363L00000XNurse Practitioner1129628TX

General Provider Information

NPI Number : 1588346902
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ADRIAN TAKEYAMA JOHNSON APRN-CNP
Provider Business Mailing Address
First Line : 3051 N ZARAGOZA RD
Second Line :
City : EL PASO
State : TX
Zip : 79938-7921
Country : US
Telephone Number : 915-401-8019
Fax Number :
Provider Business Practice Location Address
First Line : 3051 N ZARAGOZA RD
Second Line :
City : EL PASO
State : TX
Zip : 79938-7921
Country : US
Telephone Number : 915-401-8019
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2023
Last Update Date : 01/29/2026

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