Provider Demographics
NPI:1326398157
Name:JOHNSON, ALLISON F (ARNP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:F
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:FANNIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 PARKVIEW PL
Mailing Address - Street 2:(FAMILY HEALTH CENTER)
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-4550
Mailing Address - Country:US
Mailing Address - Phone:863-687-1300
Mailing Address - Fax:863-687-1305
Practice Address - Street 1:300 PARKVIEW PL
Practice Address - Street 2:(FAMILY HEALTH CENTER)
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-4550
Practice Address - Country:US
Practice Address - Phone:863-687-1300
Practice Address - Fax:863-687-1305
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2005382363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health