KELLIE NICOLE JOHNSON APRN NPI 1396975553

NPI Information

NPI: 1396975553
Provider Name: KELLIE NICOLE JOHNSON, APRN
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
1600 S 48TH ST
SUITE 600
LINCOLN, NE
ZIP 68506
Phone: (402) 483-3333
Get Directions

Kellie Nicole Johnson, APRN is an adult health nurse practitioner in Lincoln, NE with 15 years of experience. Kellie Nicole Johnson, APRN NPI is 1396975553. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1600 S 48TH ST
SUITE 600
LINCOLN, NE
ZIP 68506-283
Phone: (402) 483-3333
Fax: (402) 483-3297

The NPI 1396975553 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/22/2009 and was last updated on 11/14/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		1845	NEBRASKA	No
2	363LA2200X	Nurse Practitioner	Adult Health	111063	NEBRASKA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	47084496100	MEDICAID	NEBRASKA
2	099106003	MEDICARE PIN	NEBRASKA
3	63153	OTHER	NEBRASKA	RN LICENSE
4	1845 TEMP	OTHER	NEBRASKA	APRN LICENSE
5	111063	OTHER	NEBRASKA	APRN LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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