MRS. KELLY JARVIS JOHNSON CPNP NPI 1578048823

NPI Information

NPI: 1578048823
Provider Name: MRS. KELLY JARVIS JOHNSON, CPNP
Classification: Nurse Practitioner - 363LP0222X
Entity Type: Individual

Specialization: Pediatrics, Critical Care

PECOS Registration: Yes

Address:
2500 N STATE ST
JACKSON, MS
ZIP 39216
Phone: (601) 815-9291
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MRS. Kelly Jarvis Johnson, CPNP is a pediatrics and critical care nurse practitioner in Jackson, MS. MRS. Kelly Jarvis Johnson, CPNP NPI is 1578048823. 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:

2500 N STATE ST
JACKSON, MS
ZIP 39216-500
Phone: (601) 815-9291

The NPI 1578048823 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 10/2/2018 and was last updated on 10/24/2018.

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	208000000X	Pediatrics		902965	MISSISSIPPI	No
2	363LP0222X	Nurse Practitioner	Pediatrics, Critical Care	902965	MISSISSIPPI	Yes

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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