Individual
JEFFREY PAUL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN, FNP
Contact information
Practice address
1600 N MAIN AVE, LOVINGTON, NM 88260-2813
(575) 396-6611
Mailing address
1600 N MAIN AVE, LOVINGTON, NM 88260-2813
(575) 396-6611
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
3061
CO
163W00000X
Registered Nurse
168340
CO
363L00000X
Nurse Practitioner
10141
CO
363LF0000X
Family Nurse Practitioner
Primary
1056820
TX
363LF0000X
Family Nurse Practitioner
61768
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87703076
—
NM
05
—
96657251
—
CO
Enumeration date
10/23/2009
Last updated
03/26/2026
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