Provider Demographics
NPI:1336598895
Name:JOHNSON, JOYCE LORELLE (APRN)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:LORELLE
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 1:2410 RING RD
Mailing Address - Street 2:#500
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-7994
Mailing Address - Country:US
Mailing Address - Phone:270-765-5900
Mailing Address - Fax:
Practice Address - Street 1:2410 RING RD
Practice Address - Street 2:#500
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-7994
Practice Address - Country:US
Practice Address - Phone:270-765-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010323363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health