Provider Demographics
NPI:1912897042
Name:JOHNSON, OLUWATOSIN (APRN)
Entity type:Individual
Prefix:MRS
First Name:OLUWATOSIN
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2070 GARDEN SPRINGS DR APT 125
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3444
Mailing Address - Country:US
Mailing Address - Phone:914-330-0937
Mailing Address - Fax:
Practice Address - Street 1:2070 GARDEN SPRINGS DR APT 125
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3444
Practice Address - Country:US
Practice Address - Phone:914-330-0937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4043767363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health