Individual
KIRSTEN NATIONS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
20 COLLINS DR STE B, CARTERSVILLE, GA 30120-8533
(770) 607-0795
(770) 607-1339
Mailing address
20 COLLINS DR STE B, CARTERSVILLE, GA 30120-8533
(770) 607-0795
(770) 607-1339
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
172752
CO
363LP0200X
Pediatric Nurse Practitioner
Primary
RN139381
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000861627C
PEACH STATE ID
GA
05
—
000861627C
—
GA
01
—
049906810
CHAMPUS TRICARE
GA
01
—
10057735
AMERIGROUP
GA
01
—
336125
WELLCARE ID NUMBER
GA
01
—
5261615
CIGNA
GA
01
—
598970
BCBS
GA
Enumeration date
03/29/2006
Last updated
03/09/2021
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