Individual
MR. BRIAN KEITH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C, CRNFA, MSN
Contact information
Practice address
21200 S LAGRANGE RD, SUITE 134, FRANKFORT, IL 60423-2003
(708) 256-0816
(815) 534-5576
Mailing address
21200 S LAGRANGE RD, SUITE 134, FRANKFORT, IL 60423-2003
(708) 256-0816
(815) 534-5576
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
041-249147
IL
363LF0000X
Family Nurse Practitioner
209009090
IL
363LF0000X
Family Nurse Practitioner
Primary
NP95020729
CA
Other
Enumeration date
12/13/2006
Last updated
02/03/2025
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