Provider Demographics
NPI:1669177846
Name:JOHNSON, BRIAN KENT (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:KENT
Last Name:JOHNSON
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:643 RAY LEWIS RD
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30512-1439
Mailing Address - Country:US
Mailing Address - Phone:610-453-1548
Mailing Address - Fax:
Practice Address - Street 1:4226 E US HIGHWAY 64 ALTERNATE
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906
Practice Address - Country:US
Practice Address - Phone:828-837-8131
Practice Address - Fax:877-930-7732
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-05
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA286494363LP0808X
NC5021345363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty