Provider Demographics
NPI:1710599386
Name:JOHNSON, BRIANNA (CRNP)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 N ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36784-3529
Mailing Address - Country:US
Mailing Address - Phone:251-275-6076
Mailing Address - Fax:
Practice Address - Street 1:1531 N ANDREWS DR
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:AL
Practice Address - Zip Code:36784-3529
Practice Address - Country:US
Practice Address - Phone:251-275-6076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0002355-C-NP363LP0808X
AL1-146089363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health