Provider Demographics
NPI:1336752088
Name:JOHNSON, CHRISTY NICOLE (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:NICOLE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35768-2421
Mailing Address - Country:US
Mailing Address - Phone:256-259-5313
Mailing Address - Fax:256-259-4923
Practice Address - Street 1:60 MAIN ST N
Practice Address - Street 2:
Practice Address - City:SECTION
Practice Address - State:AL
Practice Address - Zip Code:35771
Practice Address - Country:US
Practice Address - Phone:256-228-3471
Practice Address - Fax:256-228-7289
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALF08200999207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine