Individual provider · Type 1 NPI
Melissa Kay Johnson, NP-C
Nurse Practitioner · Peoria, IL
Practice location
5409 N Knoxville Ave
Peoria, IL 61614-5069
Mailing address
801 Illini Drive, Echo Qc, Ltd
Silvis, IL 61282-1804
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | A130336 (IA) |
| Family Nurse Practitioner | 363LF0000X | F1216074 (IL) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1942744495
Melissa Kay Johnson, NP-C's National Provider Identifier is 1942744495, issued on Dec 16, 2016. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Peoria, IL. The record was last updated on Oct 30, 2025.