Individual
ANGELA JO JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
9340 CEDAR CENTER WAY, LOUISVILLE, KY 40291-4522
(502) 239-8431
(502) 239-8399
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3007832
KY
363LF0000X
Family Nurse Practitioner
Primary
3007832
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000819545
ANTHEM - NICC
KY
01
—
147633
SIHO - NICC
KY
05
—
7100242780
—
KY
Enumeration date
11/08/2012
Last updated
05/28/2019
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