Provider Demographics
NPI:1477856409
Name:JOHNS, CAROLYN MARIE (MSN, ANP-BC)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:MARIE
Last Name:JOHNS
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Gender:F
Credentials:MSN, ANP-BC
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Mailing Address - Street 1:3181 SW SAM JACKSON PARK ROAD
Mailing Address - Street 2:MAIL CODE UHN73C OHSU CENTER FOR HEMATOLOGIC MALIGNANCI
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239
Mailing Address - Country:US
Mailing Address - Phone:503-494-1551
Mailing Address - Fax:503-494-1552
Practice Address - Street 1:3181 SW SAM JACKSON PARK ROAD, KOHLER PAVILION 14 FLOOR
Practice Address - Street 2:OHSU CENTER FOR HEMATOLOGIC MALIGNANCIES
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239
Practice Address - Country:US
Practice Address - Phone:503-494-1551
Practice Address - Fax:503-494-1552
Is Sole Proprietor?:No
Enumeration Date:2010-12-14
Last Update Date:2013-06-12
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Provider Licenses
StateLicense IDTaxonomies
PASP011097363L00000X, 363LA2200X
CT004792363L00000X
OR201350105NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner