Provider Demographics
NPI:1326314782
Name:JOHNSON, KATHERINE MARGARET (APRN-FNP-BC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARGARET
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:APRN-FNP-BC
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MARGARET
Other - Last Name:AKERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 94670
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73143-4670
Mailing Address - Country:US
Mailing Address - Phone:405-682-3303
Mailing Address - Fax:
Practice Address - Street 1:2240 SUTHERLAND AVE STE 103
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919
Practice Address - Country:US
Practice Address - Phone:865-588-8831
Practice Address - Fax:868-588-8841
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN161872163W00000X
TN16631363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1529058Medicaid
TN1529058Medicaid