Provider Demographics
NPI:1154905008
Name:JOHNSON, ADRIANNE MARIE WARREN (APRN)
Entity type:Individual
Prefix:DR
First Name:ADRIANNE
Middle Name:MARIE WARREN
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 1:1022 PIERSON ROAD
Mailing Address - Street 2:
Mailing Address - City:BOONEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41314
Mailing Address - Country:US
Mailing Address - Phone:513-748-9948
Mailing Address - Fax:
Practice Address - Street 1:826 KY 11 N
Practice Address - Street 2:
Practice Address - City:BOONEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41314-9155
Practice Address - Country:US
Practice Address - Phone:606-593-6395
Practice Address - Fax:606-593-5916
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3015076363LX0106X, 363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health