Individual
MELLYN AILEEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1500 E 2ND ST, STE 100, RENO, NV 89502-1262
(775) 982-5003
(775) 982-5103
Mailing address
850 HARVARD WAY, RENO, NV 89502-2055
(775) 982-5262
(775) 982-5496
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN001367
NV
363LF0000X
Family Nurse Practitioner
Primary
APRN001367
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003181926
—
NV
01
—
12368895
CAQH
—
Enumeration date
03/09/2012
Last updated
04/22/2019
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