# MS. KIMESHIA NICOLE JOHNSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1699928655
- **Gender:** F
- **Credential:** FNP-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 679053 | TX | Yes |
| 363LF0000X | Family Nurse Practitioner | 679053 | TX | — |

## Other

- **Enumeration date:** 11/03/2008
- **Last updated:** 10/13/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0031BV | BCBS BLUE | TX |
| 01 | — | 00T71U | BCBS BLUE | TX |
| 05 | — | 323946901 | — | TX |
| 05 | — | 323946902 | — | TX |
| 01 | — | 75-0818167-022 | TRICARE | TX |
| 01 | — | 75-2616977-001 | TRICARE | TX |
| 01 | — | 75-2616977-002 | TRICARE | TX |
| 01 | — | 75-2616977-028 | TRICARE | TX |
| 01 | — | P01246227 | RAIL ROAD | TX |
| 01 | — | P01304442 | RAIL ROAD | TX |