Kennetha Doreen Johnson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

310019 Issued in KY

Practice address

12 S Bank St
Mt Sterling, KY 40353-1322

Phone

(859) 520-3044

Fax

(859) 520-3077

NPI assigned

Jan 19, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1705622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1679334353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CATHERINE ST",
            "city": "CARLISLE",
            "state": "KY",
            "postal_code": "403111206",
            "telephone_number": "859-513-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 S BANK ST",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403531322",
            "telephone_number": "859-520-3044",
            "fax_number": "859-520-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KENNETHA",
        "middle_name": "DOREEN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "KY",
            "license": "310019",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "310019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristeena Jenkins
• John I Gray III PSC
• Anne Marie Johnson
• Ashley Elizabeth Johnson, APRN
• Jon Kelly Johnson, DMD
• Margaret B Johnson, LPCC
• Monica Lynn Johnson, APRN
• Tiara Johnson
• Carol Jones
• Cassandra Jones

• Registered Nurse in Mt Sterling, KY
• Providers in Mt Sterling, KY by specialty
• Registered Nurse in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.