Kristy D. Johnson, NP-C

Individual provider Active NPI Family Nurse Practitioner · Bono, AR

NPI 1174874366 · NPPES record last updated Sep 27, 2012

Key facts

NPI
1174874366
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
A003729 (AR)
Practice address
9146 Highway 63 N
Bono, AR 72416-8153
Phone
(870) 930-9990
NPI assigned
Sep 27, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A003729 AR Yes

Addresses

Primary practice location

9146 Highway 63 N
Bono, AR 72416-8153

Mailing address

9146 Highway 63 N
Bono, AR 72416-8153
Phone (870) 930-9990

Other providers in Bono, AR

All providers in Bono, AR · Family Nurse Practitioner in Arkansas

Sources for this page

Verify at the official NPI Registry.