Most Relevant Information
Provider Data
| NPI Number: | 1003351024 |
| Provider Name: | CARIE LYNN JOHNSON APRN, NP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | APRN.CNP.020386 |
Most Important Dates
| Enumeration Date: | 12/29/2016 |
| Last Updated: | 12/29/2020 |
Provider Practice Location
12340 STATE ROUTE 104
WAVERLY
OH
456908968
Practice Location Phone/Fax
| Phone: | 7409415180 |
| Fax: | 7409415178 |
Provider Mailing Location
12340 STATE ROUTE 104
WAVERLY
OH
456908968
Provider Mailing Phone/Fax
| Phone: | 7409415180 |
| Fax: | 7409415178 |