Individual provider · Type 1 NPI
Tiesha D. Johnson, PMHNP
Psychiatric/Mental Health Nurse Practitioner · Utica, NY
NPI number
1104082346
Active
Practice location
1676 Sunset Ave
Utica, NY 13502-5416
Fax (315) 624-5401
Mailing address
111 Hospital Dr, Attn: Credentialing Dept
Utica, NY 13502
Other practice locations
- 700 Childrens Dr, Columbus, OH 43205-2639 · (614) 722-4545
- 444 Butterfly Gardens Dr, Columbus, OH 43215-3427 · (614) 938-0167
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 401131 (NY) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APRN.CNP.024042 (OH) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1104082346
Tiesha D. Johnson, PMHNP's National Provider Identifier is 1104082346, issued on Aug 6, 2008. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Utica, NY. The record was last updated on Dec 11, 2025.