Doctor Name: | DR. KAYSAN JOHNSON |
NPI Number: | 1295979854 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DNP |
License Number: | R153197 |
Business Practice Address: | 5474 Saint Barnabas Rd Oxon Hill, MD - 207453622 |
Business Phone Number: | 3018934513 |
Business Fax Number: | 2404934582 |
Mailing Address: | 5474 Saint Barnabas Rd, OXON HILL |
State: | MD |
Postal Code: | 207453622 |
Phone Number: | 3018934513 |
Fax Number: | 2404934582 |
NPI Enumeration Date: | 04/27/2009 |
NPI Last Update Date: | 10/30/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R153197 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |