Provider Demographics
NPI:1720679434
Name:JOHNSON, SARA CATHARINE (APN, MSN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:CATHARINE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:APN, MSN, FNP-BC
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:CATHARINE
Other - Last Name:KILMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:6232 LANIER RD
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37801-1131
Mailing Address - Country:US
Mailing Address - Phone:865-585-6167
Mailing Address - Fax:
Practice Address - Street 1:10800 PARKSIDE DR STE 331
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1922
Practice Address - Country:US
Practice Address - Phone:865-392-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-27
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28796363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner