Individual
KELLIE JEAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1673 W COUNTRY RD, NIXA, MO 65714-7971
(417) 439-1900
Mailing address
1673 W COUNTRY RD, NIXA, MO 65714-7971
(417) 439-1900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2025026813
MO
Other
Enumeration date
09/26/2025
Last updated
09/26/2025
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