MEDICARE: MELANIE LINDA JOHNSON FNP

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	29318	SC
2	363LF0000X	Family Nurse Practitioner	11601	TN

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	:	1629004346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE LINDA JOHNSON FNP

Provider Business Mailing Address
First Line	:	629 KENESAW AVE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37919-6660
Country	:	US
Telephone Number	:	865-250-3405
Fax Number	:

Provider Business Practice Location Address
First Line	:	7565 DANNAHER DR
Second Line	:
City	:	POWELL
State	:	TN
Zip	:	37849-4029
Country	:	US
Telephone Number	:	865-859-8000
Fax Number	:

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

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	02/11/2025

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