Provider Demographics
NPI:1861990228
Name:JOHNSON, MONICA LYNN (APRN)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:LYNN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:784 HIGHWAY 36
Mailing Address - Street 2:
Mailing Address - City:FRENCHBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40322-8123
Mailing Address - Country:US
Mailing Address - Phone:606-768-9190
Mailing Address - Fax:606-768-9180
Practice Address - Street 1:125 FOXGLOVE DR STE D
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-9735
Practice Address - Country:US
Practice Address - Phone:859-498-3333
Practice Address - Fax:859-498-3332
Is Sole Proprietor?:No
Enumeration Date:2018-01-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011481363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3011481OtherKY APRN LICENSE
KY3011481OtherKY APRN LICENSE