Kuuipo K Johnson, RN

Individual provider Active NPI Community Health Registered Nurse · Sweet Home, OR

NPI 1891949533 · NPPES record last updated Jul 22, 2016

Key facts

NPI
1891949533
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
200540143RN (OR)
Practice address
759 27TH Ave
Sweet Home, OR 97386-2994
Phone
(541) 367-8507
NPI assigned
Nov 7, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
200540143RNORMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 200540143RN OR Yes

Addresses

Primary practice location

759 27TH Ave
Sweet Home, OR 97386-2994

Mailing address

759 27TH Ave
Sweet Home, OR 97386-2994

Other providers in Sweet Home, OR

All providers in Sweet Home, OR · Community Health Registered Nurse in Oregon

Sources for this page

Verify at the official NPI Registry.