Provider Demographics
NPI:1942647771
Name:JOHNSON, KRISTIE MICHELLE (DNP, RN, NP-C)
Entity Type:Individual
Prefix:DR
First Name:KRISTIE
Middle Name:MICHELLE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DNP, RN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 LEE ROAD 537
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:AL
Mailing Address - Zip Code:36874-4782
Mailing Address - Country:US
Mailing Address - Phone:706-888-7865
Mailing Address - Fax:
Practice Address - Street 1:101 13TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-2101
Practice Address - Country:US
Practice Address - Phone:706-494-4949
Practice Address - Fax:706-494-4940
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-094247363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily