Brandy Nicole Johnson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

10 273949 Issued in NY

Practice address

58 Bert Howard Dr
Central Square, NY 13036-2391

Phone

(315) 450-4577

Fax

(315) 668-1346

NPI assigned

Jun 1, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243814400000",
    "number": "1003042367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 BERT HOWARD DR",
            "city": "CENTRAL SQUARE",
            "state": "NY",
            "postal_code": "130362391",
            "telephone_number": "315-450-4577",
            "fax_number": "315-668-1346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 BERT HOWARD DR",
            "city": "CENTRAL SQUARE",
            "state": "NY",
            "postal_code": "130362391",
            "telephone_number": "315-450-4577",
            "fax_number": "315-668-1346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRANDY",
        "middle_name": "NICOLE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-01",
        "last_updated": "2009-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "10 273949",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CT",
            "license": "033832",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Janecek, RPH
• Aaron Jannetti
• Trevor Mark Janus
• Claudia Jenks
• Elizabeth Maureen Jenners
• Leona Sarah Johnson, LPN
• Marie S Karboski
• Lisa M Kelley, R.N.
• Danielle Kerfien, FNP
• Tamara Lynn Keys, LPN

• Licensed Practical Nurse in Central Square, NY
• Providers in Central Square, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.