Johnna Marie Edmunds, FNP

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

204315 Issued in CA

Practice address

775 Baywood Dr
Petaluma, CA 94954-5501

Phone

(707) 765-2425

NPI assigned

Aug 15, 2007

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

Other identifiers 1

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": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187136000000",
    "number": "1912199753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 SONOMA MOUNTAIN RD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949549201",
            "telephone_number": "707-664-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 BAYWOOD DR",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949545501",
            "telephone_number": "707-765-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMUNDS",
        "first_name": "JOHNNA",
        "middle_name": "MARIE",
        "name_prefix": "Prof.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2007-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "204315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA STATE LIC. NO.",
            "identifier": "13725 NP",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wesley Easley
• Jeff Eaton, BCBA
• Scott W. Eberle, M.D.
• Juan Echeverria
• Kaila Alexandra Eddy-Cooke
• Philippe Edouard, MD
• Marina Elizabeth Eggleston
• Iverson M. Eicken, PH.D.
• Eiler Sommerhaug MD Inc
• Nikki Einfeld, MS, AMFT, APCC

• Registered Nurse in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; 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.