Provider Demographics
NPI:1255137725
Name:JOHNSON, TERRIKA ANN (PNP-AC)
Entity type:Individual
Prefix:DR
First Name:TERRIKA
Middle Name:ANN
Last Name:JOHNSON
Suffix:
Gender:
Credentials:PNP-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 STONEWATER CREEK DR APT D
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-6119
Mailing Address - Country:US
Mailing Address - Phone:731-414-2707
Mailing Address - Fax:
Practice Address - Street 1:2220 PATTERSON STREET
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203
Practice Address - Country:US
Practice Address - Phone:615-342-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36718363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics