Individual
MARLA SMITH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-2000
(859) 301-6910
Mailing address
PO BOX 636324, CINCINNATI, OH 45263-6324
(859) 301-2000
(859) 301-6910
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3003587
KY
363L00000X
Nurse Practitioner
71014669A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000225922
ANTHEM
—
05
—
0052920
—
OH
05
—
201127110
—
IN
01
—
500023900
PALMETTO GBA-RAILROAD MEDICARE
—
05
—
78006681
—
KY
01
—
P00942703
RAIL ROAD MEDICARE
KY
01
—
P00954941
RAIL ROAD MEDDICARE
KY
Enumeration date
06/17/2005
Last updated
12/18/2025
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