Provider Demographics
NPI:1174769129
Name:JOHNSON, CHRISTIN LEIGHANN (FNP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTIN
Middle Name:LEIGHANN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:CHRISTIN
Other - Middle Name:LEIGHANN
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1021 W OAKLAND AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2192
Mailing Address - Country:US
Mailing Address - Phone:423-302-6565
Mailing Address - Fax:
Practice Address - Street 1:1021 W OAKLAND AVE STE 301
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2192
Practice Address - Country:US
Practice Address - Phone:423-952-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-22
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000153445363LF0000X
TNAPN0000013997363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1514956Medicaid
8331745OtherCIGNA
8331745OtherCIGNA