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Individual

MOLLY JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1408 CAMPBELL DR, IRONTON, OH 45638-2301
(740) 534-9195
(740) 534-9327
Mailing address
305 N 5TH ST, IRONTON, OH 45638-1578
(740) 532-4858
(740) 532-4859

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4632P
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000380503
ANTHEM BCBS
KY
01
000000609842
ANTHEM BCBS
KY
05
1437181104
WV
05
2830119
OH
05
78015401
KY
Enumeration date
07/06/2006
Last updated
03/17/2018
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