Provider Demographics
NPI:1992172373
Name:JOHNSON, JAMIE KRISTIN (DNP, CRNP)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:KRISTIN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DNP, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:758 BROOKLINE CIR
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-6601
Mailing Address - Country:US
Mailing Address - Phone:205-529-9136
Mailing Address - Fax:
Practice Address - Street 1:1940 ELMER J BISSELL RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-2941
Practice Address - Country:US
Practice Address - Phone:205-638-4823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-01
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-096229363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily