Provider Demographics
NPI:1073698692
Name:JOHNSON, MARGARET E (MSN)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:E
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4727 ROSEBUD LN
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-9367
Mailing Address - Country:US
Mailing Address - Phone:812-429-0772
Mailing Address - Fax:812-389-0877
Practice Address - Street 1:4727 ROSEBUD LN
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-9367
Practice Address - Country:US
Practice Address - Phone:812-429-0772
Practice Address - Fax:812-389-0877
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71006624A363LP0808X
UT12788915-4405363LP0808X
KY3008080363LP0808X
TN14882363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health