Johnson, Marla Smith

Johnson, Marla Smith is an individual health care provider with primary practice located at 1 Medical Village Dr , Edgewood KY 41017-3403. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Johnson, Marla Smith can be contacted via phone (859) 301-2000.

Contact Information

Primary practice address
1 Medical Village Dr Edgewood KY 41017-3403
Phone: (859) 301-2000
Fax: (859) 426-4140
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 71014669A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 3003587 Kentucky

Profile Details

NPI number 1104821982
LBN Legal business name Johnson, Marla Smith
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated Jun 19th, 2024 - about 5 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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Identifiers

StateTypeNumberIssuer
All States NPI 1104821982 NPPES
Indiana MEDICAID 201127110
Indiana Other 500023900
Indiana MEDICAID 0052920
Indiana Other P00954941
Indiana MEDICAID 78006681
Indiana Other 000000225922
Indiana Other P00942703

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