Provider Demographics
NPI:1598946741
Name:JOHNSON, JUNICE L (MSN, NP-C)
Entity Type:Individual
Prefix:MS
First Name:JUNICE
Middle Name:L
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 AKERS AVE
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3720
Mailing Address - Country:US
Mailing Address - Phone:812-283-2308
Mailing Address - Fax:812-283-2309
Practice Address - Street 1:1301 AKERS AVE
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3720
Practice Address - Country:US
Practice Address - Phone:812-283-2308
Practice Address - Fax:812-283-2309
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28162372A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily