Johnson, Desiree L
Johnson, Desiree L is an individual health care provider with primary practice located at 650 Joel Dr , Fort Campbell KY 42223-5318. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Johnson, Desiree L can be contacted via phone (270) 798-8727.Contact Information
Primary practice address
650 Joel Dr
Fort Campbell KY 42223-5318
Phone: (270) 798-8727
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA04614 | Texas |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA04614 | Texas |
Profile Details
| NPI number | 1174589782 |
|---|---|
| LBN Legal business name | Johnson, Desiree L |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 22nd, 2006 |
| Last updated | Jan 22nd, 2024 - about 10 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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