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Provider Information for 1417090523

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

MS. KAREN L JOHNSON ARNP

Gender: FEMALE

Individual NPI: 1417090523

Calendar   Last Updated:  2018-02-26
  Certification Date: 

Details

Name Value
NPI 1417090523
Enumeration Date 2007-02-15
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 1839 CENTRAL AVE
ST PETERSBURG, FL 33713-8900
United States

Phone: 727-322-1054 | Fax: 727-322-2725
View Map External Link
Primary Practice Address 1839 CENTRAL AVE
ST PETERSBURG, FL 33713-8900
United States

Phone: 727-322-1054 | Fax: 727-322-2725
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID FL 002122800
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 363LF0000X - Nurse Practitioner Family FL 2623012
No 363LF0000X - Nurse Practitioner Family FL ARNP2623012