MEDICARE: VICTORIA JOHNSON NP

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	29865	SC

General Provider Information

NPI Number	:	1871304360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA JOHNSON NP

Provider Business Mailing Address
First Line	:	569 HILLPARK LN
Second Line	:
City	:	GREER
State	:	SC
Zip	:	29651-0801
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2746 BOILING SPRINGS RD
Second Line	:
City	:	BOILING SPRINGS
State	:	SC
Zip	:	29316-6003
Country	:	US
Telephone Number	:	864-586-3923
Fax Number	:

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

Provider Enumeration Date	:	01/15/2025
Last Update Date	:	01/15/2025

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