Provider Demographics
NPI:1467739623
Name:JOHNS, MARJORY K (FNP)
Entity Type:Individual
Prefix:
First Name:MARJORY
Middle Name:K
Last Name:JOHNS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 JULIE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-3224
Mailing Address - Country:US
Mailing Address - Phone:615-754-6055
Mailing Address - Fax:615-284-5021
Practice Address - Street 1:2006 JULIE DR
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3224
Practice Address - Country:US
Practice Address - Phone:615-754-6055
Practice Address - Fax:615-284-5021
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000005343363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily