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NPI Code Detail

MEDICARE: DEREK ELI JOHNSON APRN

MEDICARE: DEREK ELI JOHNSON APRN
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
1163WP0808XPsychiatric/Mental Health Registered NurseRN99367NV
2363LP0808XPsychiatric/Mental Health Nurse Practitioner898146NV

General Provider Information

NPI Number : 1811846611
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEREK ELI JOHNSON APRN
Provider Business Mailing Address
First Line : 6600 W CHARLESTON BLVD STE 142
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-1050
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6600 W CHARLESTON BLVD STE 142
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-1050
Country : US
Telephone Number : 320-260-7472
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2026
Last Update Date : 02/02/2026

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Directions to “ DEREK ELI JOHNSON APRN” Practice Location

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