Provider Demographics
NPI:1871845156
Name:JOHNSON, CARRIE NICOLE (RN)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:NICOLE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 JOY ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-4529
Mailing Address - Country:US
Mailing Address - Phone:731-642-4025
Mailing Address - Fax:
Practice Address - Street 1:803 JOY ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-4529
Practice Address - Country:US
Practice Address - Phone:731-642-4025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN173073163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health