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

TaxonomyCodeLicense
Acute Care Nurse Practitioner Primary 363LA2100X127783 (WV)
Critical Care Medicine Registered Nurse 163WC0200X99235 (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.