Kristin Lynn Johnson, R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

628344-1 Issued in NY

Practice address

249 Woodhull Ave
Port Jefferson Station, NY 11776-1327

Phone

(631) 258-8294

NPI assigned

Oct 6, 2011

Sex

Female

Sole proprietor

Yes

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": "1317859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1497039622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 WOODHULL AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761327",
            "telephone_number": "631-258-8294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 WOODHULL AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761327",
            "telephone_number": "631-258-8294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KRISTIN",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-06",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "628344-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanne Della Valle LCSW P.C.
• John T. Mather Memorial Hospital
• Shirley Johnson-Hall, MD
• Colleen Breen Johnson, PA-C
• Kathy Marie Johnson, OTR
• Melissa Johnson, M.S.ED.
• Sandy J Johnson, LMFT
• Mary Ellen M Johnston, L-RCSW
• Toni Lee Johnston, NP
• Margaret R Jongebloed

• Registered Nurse in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; 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.