Individual
KATHERINE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Taxonomy
Speciality
Code
Description
License number
State
163WC1600X
Continuing Education/Staff Development Registered Nurse
NUR-RN-LIC-174252
MT
363LP0200X
Pediatric Nurse Practitioner
Primary
8771895
ID
363LP0200X
Pediatric Nurse Practitioner
NUR-APRN-LIC-2291900
MT
Other
Enumeration date
02/03/2026
Last updated
08/07/2026
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