Carolyn Johnson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

818308 Issued in MN

Practice address

3333 Harbor LN N Apt 6-303
Plymouth, MN 55447-8854

Phone

(208) 699-1276

NPI assigned

Jan 30, 2022

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

State licenses

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

{
    "created_epoch": "1643500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643500800000",
    "number": "1760135826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 HARBOR LN N APT 6-303",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554478854",
            "telephone_number": "208-699-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 HARBOR LN N APT 6-303",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554478854",
            "telephone_number": "208-699-1276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CAROLYN",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-30",
        "last_updated": "2022-01-30",
        "certification_date": "2022-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MN",
            "license": "818308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Lynn Johns, PHARMD
• Christine Marie Johnson Weber
• Alison Dawn Johnson, COTA/L
• Andrew Ryan Johnson, DC
• Brett Ryser Johnson, CRNA
• Courtney Marie Johnson
• David S. Johnson, MD
• Jaclyn Rachel Johnson, MA, LPCC, LADC
• Jashae Johnson
• Julia Aletta Johnson

• Licensed Practical Nurse in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Licensed Practical Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2022; 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.