Provider Demographics
NPI:1720787658
Name:JOHNSON, KATHERINE L (DNP, FNP-C)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:L
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 HARBOUR HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-2141
Mailing Address - Country:US
Mailing Address - Phone:301-904-8059
Mailing Address - Fax:
Practice Address - Street 1:25500 POINT LOOKOUT RD STE 250
Practice Address - Street 2:
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-2015
Practice Address - Country:US
Practice Address - Phone:240-434-7474
Practice Address - Fax:855-675-5992
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR211668363LF0000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse