Individual
MR. ROBERT JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
104 HARDIN LN STE A, SOMERSET, KY 42503
(606) 678-8323
(606) 678-0496
Mailing address
104 HARDIN LN STE A, SOMERSET, KY 42503-3800
(606) 678-8323
(606) 451-0963
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3011600
KY
363LG0600X
Gerontology Nurse Practitioner
3011600
KY
Other
Enumeration date
10/09/2017
Last updated
07/21/2020
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