Provider Demographics
NPI:1588442727
Name:JOHNSON, KRIS C (RN)
Entity type:Individual
Prefix:
First Name:KRIS
Middle Name:C
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2328 POINT MALLARD DR SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-6742
Mailing Address - Country:US
Mailing Address - Phone:256-616-2743
Mailing Address - Fax:
Practice Address - Street 1:2328 POINT MALLARD DR SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-6742
Practice Address - Country:US
Practice Address - Phone:256-616-2743
Practice Address - Fax:256-552-1143
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1096537163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health