Provider Demographics
NPI:1386150001
Name:JOHNSON, KERRI A (ARNP)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:A
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KERRI
Other - Middle Name:A
Other - Last Name:KLEMMENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5100 PRAIRIE PKWY STE 302
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-8155
Mailing Address - Country:US
Mailing Address - Phone:319-277-1990
Mailing Address - Fax:319-277-0572
Practice Address - Street 1:5100 PRAIRIE PKWY STE 302
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-8155
Practice Address - Country:US
Practice Address - Phone:319-277-1990
Practice Address - Fax:319-277-0572
Is Sole Proprietor?:No
Enumeration Date:2017-12-18
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA135178363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily