Individual
MRS. DEBRA JEAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
407 MAIN ST, GOLDEN CITY, MO 64748-8266
(417) 537-4311
(417) 537-4330
Mailing address
407 MAIN ST, GOLDEN CITY, MO 64748-8266
(417) 537-4311
(417) 537-4330
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F0499281
MO
364S00000X
Clinical Nurse Specialist
073423
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000050010
MEDICARE GROUP NUMBER
MO
01
—
268625
MEDICARE RHC GROUP NUMBER
MO
Enumeration date
05/17/2007
Last updated
07/24/2015
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