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Individual

LAURA JEAN JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
5800 BANNON CROSSINGS DR, LOUISVILLE, KY 40228-1189
(502) 216-6140
Mailing address
5800 BANNON CROSSINGS DR, LOUISVILLE, KY 40228-1189
(502) 216-6140

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1136964
KY
363LF0000X
Family Nurse Practitioner
28248284A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300047339
IN
Enumeration date
01/30/2019
Last updated
09/28/2021
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