Provider Demographics
NPI:1376968842
Name:JOHNSON, JOANNA LYNN (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:LYNN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:LYNN
Other - Last Name:EMMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ACNS-BC
Mailing Address - Street 1:901 SAINT MARYS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-0509
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:901 SAINT MARYS DR STE 200
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714
Practice Address - Country:US
Practice Address - Phone:812-485-6030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-20
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003702A363LG0600X, 364SA2200X, 364SC0200X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine