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Organization
1025 HEALTH, LLC
Active
Organization
1025 HEALTH, LLC
Active
Parent organization
1104270
Organization subpart
Yes
Provider details
NPI number
Legal business name
1104270
Authorized official
MR. ROBERT JOHNSON APRN (NP)
(606) 451-9748
Entity
Organization
Contact information
Practice address
110 HARDIN LN, SOMERSET, KY 42503-3818
(606) 451-9748
Mailing address
110 HARDIN LN, SOMERSET, KY 42503-3818
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
363LG0600X
Gerontology Nurse Practitioner
—
NULL
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Enumeration date
07/21/2020
Last updated
07/21/2020
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