Provider Demographics
NPI:1912011982
Name:JOHNSON, MARGARET R (FNP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:R
Last Name:JOHNSON
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:PO BOX 200149
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99520-0149
Mailing Address - Country:US
Mailing Address - Phone:907-561-3211
Mailing Address - Fax:907-562-7547
Practice Address - Street 1:3841 PIPER STREET
Practice Address - Street 2:SUITE T100
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-561-3211
Practice Address - Fax:907-562-7547
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK594363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1022515Medicaid
AKP00372556OtherRAILROAD MEDICARE
AK8EA689Medicare ID - Type Unspecified
AKP71894Medicare UPIN
AKK162623Medicare PIN
AKK160848Medicare PIN