Individual
DEBRA A JOHNSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
3120 BURNET AVE, CINCINNATI, OH 45229-3091
(513) 584-8600
(513) 584-8620
Mailing address
PO BOX 636256 CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5501
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-03967
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200508940
—
IN
05
—
2499167
—
OH
05
—
78012465
—
KY
01
—
P00194628
RAIL ROAD MEDICARE
OH
Enumeration date
05/04/2006
Last updated
01/19/2018
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