Provider Demographics
NPI:1043954266
Name:JOHNSON, JULIE ELIZABETH (CRNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ELIZABETH
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 CAMPGROUND CIR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35769-3446
Mailing Address - Country:US
Mailing Address - Phone:256-599-6464
Mailing Address - Fax:
Practice Address - Street 1:1601 VETERANS DR STE 107
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35769-3717
Practice Address - Country:US
Practice Address - Phone:256-999-0337
Practice Address - Fax:256-999-0335
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-141090363LF0000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse