# DEBRA V JOHNSON, APRN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093277709
- **Authorized official:** SUE ROACH (BILLING ADMINISTRATOR)
- **Authorized official phone:** (860) 368-7092

## Contact information

- **Practice address:** 35 TOWER LN, UNIT 102, AVON, CT 06001-4237
- **Practice address phone:** (860) 983-0655
- **Mailing address:** 22 TRAINOR DR, WEATOGUE, CT 06089-9613
- **Mailing address phone:** (860) 983-0655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/02/2019
- **Last updated:** 04/02/2019