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Individual
KIRSTEN NATIONS JOHNSON
Active
Individual
KIRSTEN NATIONS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
172752
CO
363LP0200X
Pediatric Nurse Practitioner
Primary
RN139381
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000861627C
PEACH STATE ID
GA
05
—
000861627C
—
GA
01
—
049906810
CHAMPUS TRICARE
GA
01
—
10057735
AMERIGROUP
GA
01
—
336125
WELLCARE ID NUMBER
GA
01
—
5261615
CIGNA
GA
01
—
598970
BCBS
GA
Enumeration date
03/29/2006
Last updated
03/09/2021
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