Individual provider · Type 1 NPI
Elliot Laine Johnson
Acute Care Nurse Practitioner · South Charleston, WV
NPI number
1871419861
Active
Practice location
4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Mailing address
910 S Walnut St
St. Albans, WV 25177-3945
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acute Care Nurse Practitioner Primary | 363LA2100X | 127783 (WV) |
| Critical Care Medicine Registered Nurse | 163WC0200X | 99235 (WV) |
Acute Care Nurse Practitioner: Definition to come...
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About NPI 1871419861
Elliot Laine Johnson's National Provider Identifier is 1871419861, issued on Jun 25, 2026. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in South Charleston, WV. The record was last updated on Oct 26, 2026.