Individual
KEVIN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, FNP-C
Contact information
Practice address
1055 N 500 W STE 205, PROVO, UT 84604-3305
(801) 429-8095
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8262328-4405
UT
Other
Enumeration date
10/02/2019
Last updated
11/27/2023
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