Individual
KRISTEN AILI JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC, FNP-C
Contact information
Practice address
3674 S WASHINGTON ST, GRAND FORKS, ND 58201
(701) 205-3000
Mailing address
PO BOX 84101, SEATTLE, WA 98124-5401
(907) 335-7500
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
F102001180
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R53273
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15154247
CAQH
—
05
—
1733819
—
AK
01
—
Q00086344
RR PTAN
—
Enumeration date
11/05/2020
Last updated
04/13/2026
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