Individual provider · Type 1 NPI
Trevor R. Johnson
Primary Care Nurse Practitioner · Waterloo, NY
NPI number
1669347951
Active
Practice location
367 E Main St Ste A
Waterloo, NY 13165-1643
Mailing address
4603 Witherden Rd
Marion, NY 14505-9319
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | F357797-01 (NY) |
Primary Care Nurse Practitioner: Definition to come...
6 other providers at this address
- Agata Katarzyna Olszowska, MDFamily Medicine Physician Waterloo, NY NPI 1760406177
- Elizabeth Marie SmithPrimary Care Nurse Practitioner Waterloo, NY NPI 1730712985
- Jamie Lynn Barber, NPAdult Health Nurse Practitioner Waterloo, NY NPI 1750935565
- Luke B. Chen, MDInternal Medicine Physician Waterloo, NY NPI 1700889243
- Malaika Briged Joseph, MDHospice and Palliative Medicine (Family Medicine) Physician Waterloo, NY NPI 1457098881
- Michael Robert Kozlowski, DOFamily Medicine Physician Waterloo, NY NPI 1649910464
Other primary care nurse practitioner providers in Waterloo
About NPI 1669347951
Trevor R. Johnson's National Provider Identifier is 1669347951, issued on Oct 7, 2025. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Waterloo, NY. The record was last updated on Oct 7, 2025.