Individual
KELLIE NICOLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1600 S 48TH ST, SUITE 600, LINCOLN, NE 68506-1283
(402) 483-3333
(402) 483-3297
Mailing address
1600 S 48TH ST, SUITE 600, LINCOLN, NE 68506-1283
(402) 483-3333
(402) 483-3297
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1845
NE
363LA2200X
Adult Health Nurse Practitioner
Primary
111063
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111063
APRN LICENSE
NE
01
—
1845 TEMP
APRN LICENSE
NE
05
—
47084496100
—
NE
01
—
63153
RN LICENSE
NE
Enumeration date
07/22/2009
Last updated
11/14/2011
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