Petra Kimberly John

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

334763-1 Issued in NY

Practice address

1873 Eastern Pkwy
Brooklyn, NY 11233-3214

Phone

(718) 498-1001

NPI assigned

Nov 7, 2019

Last updated

Nov 7, 2019By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1700421245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 E 95TH ST APT 1F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112122905",
            "telephone_number": "347-993-5026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1873 EASTERN PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112333214",
            "telephone_number": "718-498-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "PETRA",
        "middle_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "334763-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary John
• Melissa Christina John, RN
• Mignole John
• Minnie John, M.D.
• Noderea John, LCSW
• Ranisha John
• Roberta John
• Roshan John, MBBS
• Sabu John, M.D
• Shakira A John

• Licensed Practical Nurse in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; 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.