Johnson, Edalyn Kay
Johnson, Edalyn Kay is an individual health care provider with primary practice located at 4550 Eubank Blvd Ne Suite 105, Albuquerque NM 87111-3479. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Johnson, Edalyn Kay can be contacted via phone (505) 296-1120.Contact Information
Primary practice address
4550 Eubank Blvd Ne Suite 105
Albuquerque NM 87111-3479
Phone: (505) 296-1120
Fax: (505) 296-1121
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Registered Nurse | 163W00000X | R17788 | New Mexico |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | R17788 | New Mexico |
Profile Details
| NPI number | 1710935200 |
|---|---|
| LBN Legal business name | Johnson, Edalyn Kay |
| Credentials | Certified Nurse Practitioner (CNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 5th, 2006 |
| Last updated | May 20th, 2008 - about 16 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710935200 | NPPES |
| New Mexico | Other | 743032990 | TRIWEST |
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