Robert Andrew Johnson, RN

Individual provider Active NPI General Practice Registered Nurse · Church Hill, TN

NPI 1225754724 · NPPES record last updated Oct 17, 2022

Key facts

NPI
1225754724
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Registered Nurse 163WG0000X
License
0000180561 (TN)
Practice address
247 Silver Lake Rd
Church Hill, TN 37642-3516
Phone
(142) 335-7534
NPI assigned
Oct 17, 2022
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0000180561TNMDGeneral Practice Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 0000180561 TN Yes

Addresses

Primary practice location

247 Silver Lake Rd
Church Hill, TN 37642-3516

Mailing address

247 Silver Lake Rd
Church Hill, TN 37642-3516
Phone (142) 335-7534

Other providers in Church Hill, TN

All providers in Church Hill, TN · General Practice Registered Nurse in Tennessee

Sources for this page

Verify at the official NPI Registry.