Provider Demographics
NPI:1194208900
Name:JOHNSON, GEORGINA L (APRN, NP-C)
Entity type:Individual
Prefix:
First Name:GEORGINA
Middle Name:L
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10820 RAMONA CIR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-9352
Mailing Address - Country:US
Mailing Address - Phone:402-770-9115
Mailing Address - Fax:
Practice Address - Street 1:10820 RAMONA CIR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-9352
Practice Address - Country:US
Practice Address - Phone:402-770-9115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-08
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112548363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily