Individual
MRS. KELSEY R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1650 COWLES ST, FAIRBANKS, AK 99701-5907
(907) 458-5250
Mailing address
3375 HILLARY AVE, FAIRBANKS, AK 99709-5850
(907) 322-7928
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
129303
AK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
239198
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1756131
—
AK
Enumeration date
04/23/2025
Last updated
07/29/2025
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