Kristina Lynn Johnson, RN, AGCNS-BC

Primary specialty

Critical Care Medicine Clinical Nurse SpecialistTaxonomy code 364SC0200X

License

4704276680 Issued in MI

Practice address

2799 W Grand Blvd
Detroit, MI 48202-2689

Phone

(313) 916-3714

NPI assigned

Jul 15, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1245802503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022689",
            "telephone_number": "313-916-3714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022689",
            "telephone_number": "313-916-3714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KRISTINA",
        "middle_name": "LYNN",
        "credential": "RN, AGCNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SC0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Critical Care Medicine",
            "state": "MI",
            "license": "4704276680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Lee Johnson, P.T.,O.T.
• Kevin Johnson, S.W.
• Kiera Johnson
• Kimberly Johnson
• Kristin Johnson, MSW, LLMSW
• Krystal Johnson
• Lakierra Johnson
• Latrice Johnson
• Laurel Johnson, M.ED, CHES
• Lauryn Johnson, LLBSW

• Clinical Nurse Specialist in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Nurse Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.