Provider Demographics
NPI:1982277117
Name:JOHNS, KIMONE LATOYA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KIMONE
Middle Name:LATOYA
Last Name:JOHNS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 BENSLEY PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23237-1787
Mailing Address - Country:US
Mailing Address - Phone:917-856-6295
Mailing Address - Fax:
Practice Address - Street 1:10301 COLONY VILLAGE WAY APT 205
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23237-3340
Practice Address - Country:US
Practice Address - Phone:917-856-6295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-24
Last Update Date:2021-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024182166363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily