Provider Demographics
NPI:1427656867
Name:JOHNSON, KARLEIGH ZAN (FNP-C)
Entity type:Individual
Prefix:
First Name:KARLEIGH
Middle Name:ZAN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 STUDENT CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-4601
Mailing Address - Country:US
Mailing Address - Phone:512-245-2161
Mailing Address - Fax:
Practice Address - Street 1:298 STUDENT CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-4601
Practice Address - Country:US
Practice Address - Phone:512-245-2161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-16
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1014950363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily