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Ms. Kimeshia Nicole Johnson, FNP-C
Nurse Practitioner in Tyler, Texas
NPI 1699928655

Kimeshia Nicole Johnson is a Nurse Practitioner based in Dallas, TX. Kimeshia Nicole Johnson practices in Tyler, TX and has the professional credentials of FNP-C. The NPI Number for Kimeshia Nicole Johnson is 1699928655 and holds a License No. 679053 (Texas).

The current practice location address for Kimeshia Nicole Johnson is 5414 S Broadway Ave, Tyler, TX and can be reached out via phone at 903-581-1601 and via fax at 903-581-1638.

Location: 5414 S Broadway Ave, Tyler, TX, 75284-1656
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1699928655
Provider Name
Kimeshia Nicole Johnson
Credential
FNP-C
Provider Entity Type
Individual
Gender
Female
Address
5414 S Broadway Ave, Tyler, TX, 75284-1656
Phone Number
903-581-1601
Fax Number
903-581-1638
Provider Enumeration Date
11/03/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
75-2616977-001 01 TX TRICARE
P01246227 01 TX RAIL ROAD
P01304442 01 TX RAIL ROAD
323946901 05 TX
0031BV 01 TX BCBS BLUE
75-0818167-022 01 TX TRICARE
00T71U 01 TX BCBS BLUE
75-2616977-002 01 TX TRICARE
75-2616977-028 01 TX TRICARE
323946902 05 TX
institution
Provider Business Practice Location Address Details
Address
5414 S Broadway Ave
City
Tyler
State
Texas
Zip
75703-1335
Phone Number
903-581-1601
Fax Number
903-581-1638
person
Provider Business Mailing Address Details
Address
5414 S Broadway Ave
City
Tyler
State
Texas
Zip
75703-1335
Phone Number
903-581-1601
Fax Number
903-581-1638
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
679053 (Texas)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
679053 (Texas)
Definition
Definition to come...
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