| Doctor Name: | MRS. KELLY ANN JOHNSON |
| NPI Number: | 1255652509 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN, NP-C |
| License Number: | 111131 |
| Business Practice Address: | 372 S 9th St David City, NE - 686322116 |
| Business Phone Number: | 4023671378 |
| Business Fax Number: | |
| Mailing Address: | 372 S 9th St, DAVID CITY |
| State: | NE |
| Postal Code: | 686322116 |
| Phone Number: | 4023671378 |
| Fax Number: | |
| NPI Enumeration Date: | 06/21/2010 |
| NPI Last Update Date: | 06/21/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 111131 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |