Individual provider · Type 1 NPI
Kelly Jarvis Johnson, CPNP
Critical Care Pediatric Nurse Practitioner · Jackson, MS
NPI number
1578048823
Active
Practice location
2500 N State St
Jackson, MS 39216-4500
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatrics Physician | 208000000X | 902965 (MS) |
| Critical Care Pediatric Nurse Practitioner Primary | 363LP0222X | 902965 (MS) |
Critical Care Pediatric Nurse Practitioner: Definition to come...
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About NPI 1578048823
Kelly Jarvis Johnson, CPNP's National Provider Identifier is 1578048823, issued on Oct 2, 2018. The primary taxonomy on file is Critical Care Pediatric Nurse Practitioner (363LP0222X), and the practice location is in Jackson, MS. The record was last updated on Oct 24, 2018.