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NPI Code Detail

MEDICARE: KIMBERLY ELLEN JOHNSON FNP

MEDICARE: KIMBERLY ELLEN 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
1363LF0000XFamily Nurse Practitioner216738MT

General Provider Information

NPI Number : 1942987144
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY ELLEN JOHNSON FNP
Provider Business Mailing Address
First Line : 1285 VIRGINIA AVE
Second Line :
City : NORTH BEND
State : OR
Zip : 97459-2715
Country : US
Telephone Number : 541-751-7908
Fax Number : 541-615-9303
Provider Business Practice Location Address
First Line : 1401 25TH ST S
Second Line :
City : GREAT FALLS
State : MT
Zip : 59405-5183
Country : US
Telephone Number : 406-731-8030
Fax Number : 406-731-8318
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2023
Last Update Date : 06/17/2026

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Directions to “ KIMBERLY ELLEN JOHNSON FNP” Practice Location

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