Leslie Renee Johnson, BSN, RN
Individual provider Active NPI Registered Nurse · St. Joseph, IL
NPI 1619908308 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1619908308
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- Practice address
- 204 N. Main
St. Joseph, IL 61873-8431 - Phone
- (217) 469-2232
- Fax
- (217) 469-2381
- NPI assigned
- Jul 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041-346937 | IL | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | IL | Yes |
Addresses
Primary practice location
204 N. Main
St. Joseph, IL 61873-8431
Mailing address
1702 Locust Dr
Saint Joseph, IL 61873-8431
Phone (217) 637-3782
Other providers in St. Joseph, IL
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- Jill Elizabeth Kellner
- Tony Yung Kirkman
- CHI Kim Le
- Megan Catherine Learned
- Ricky Mahajan
All providers in St. Joseph, IL · Registered Nurse in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.