Active NPI
Kjersten Johnsen, APN
- Psychiatric/Mental Health Clinical Nurse Specialist
- Watertown, MA
National Provider Identifier
1407172588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Clinical Nurse Specialist
- License
- RN17902
- Practice address
- 290 Pleasant St
102
Watertown, MA 02472-2427 - Phone
- (617) 571-9221
- NPI assigned
- Apr 14, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Clinical Nurse Specialist | 364SP0808X | RN17902 | MA | Primary |
Addresses
Primary practice location
290 Pleasant St
102
Watertown, MA 02472-2427
Mailing address
290 Pleasant St
102
Watertown, MA 02472-2427
Phone (617) 571-9221
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN17902 | MA | MD | Psychiatric/Mental Health Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271203200000",
"number": "1407172588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "290 PLEASANT ST",
"address_2": "102",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024722427",
"telephone_number": "617-571-9221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 PLEASANT ST",
"address_2": "102",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024722427",
"telephone_number": "617-571-9221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSEN",
"first_name": "KJERSTEN",
"credential": "APN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-14",
"last_updated": "2010-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "364SP0808X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
"state": "MA",
"license": "RN17902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.