Individual
MR. PAUL KIRK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
3333 W 20TH ST, JACKSONVILLE, FL 32254-1703
(904) 695-9145
(904) 695-2465
Mailing address
PO BOX 19189, JACKSONVILLE, FL 32245-9189
(904) 743-1883
(904) 743-5109
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP2557342
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0708861
—
FL
Enumeration date
08/30/2006
Last updated
08/19/2009
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