CAROLYN JO JOHNSON (NPI# 1205107448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205107448 |
| Entity Type | Individual |
| Full Name | CAROLYN JO JOHNSON |
| Credential | APRN, PMHNP |
| Practice Address |
107 Dilworth St Glendive MT 59330-2053 |
| Practice Telephone | (307) 762-9999 |
| Mailing Telephone | (307) 762-9999 |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2017-09-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
108044 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
22618.1145 | WY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053918235 | Carolyn Ann Johnson | Counselor | 15362 E 12th St, Tulsa, OK 74108-4710 | 2020-10-01 |
| 1174171003 | Carolyn Elizabeth Johnson | Speech-Language Pathologist | 12375 Aden Rd, Nokesville, VA 20181-2320 | 2019-09-04 |
| 1013565183 | Carolyn Lee Johnson | Nurse's Aide | 166b Smokey Rdg, Onalaska, WA 98570-9452 | 2019-08-30 |
| 1114482569 | Carolyn Johnson | Nurse Practitioner | 13462 Hwy 110 N, Tyler, TX 75704-2444 | 2019-02-08 |
| 1669975587 | Carolyn S Johnson | Registered Nurse | 1027 French Rd, Indianola, MS 38751-9605 | 2018-03-16 |
| 1093215543 | Carolyn Johnson | Licensed Vocational Nurse | 2310 Buck Dr, Tyler, TX 75701-2406 | 2018-02-20 |
| 1043763485 | Carolyn Johnson | Occupational Therapist | 9241 Vendome Dr, Bethesda, MD 20817-4029 | 2016-08-02 |
| 1780097873 | Carolyn Johnson | Home Health Aide | 113 Stone Dr, Anderson, SC 29625-2710 | 2014-06-05 |
| 1124392410 | Carolyn Amanda Johnson | Licensed Practical Nurse | 422 E 35th St, Brooklyn, NY 11203-5010 | 2012-03-03 |
| 1912282153 | Carolyn J Johnson | Pharmacist | 3184 London Rd, Eau Claire, WI 54701 | 2011-10-19 |
| Street Address |
107 DILWORTH ST |
| City | GLENDIVE |
| State | MT |
| Zip Code | 59330-2053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659374130 | Ericca S Berry | Nurse Practitioner | 107 Dilworth St, Glendive, MT 59330-2053 | 2005-05-27 |
| 1821654518 | Calvin Wiese | Counselor | 107 Dilworth St, Glendive, MT 59330-2053 | 2019-05-17 |
| 1770965972 | Nena Panasuk | Family Medicine | 107 Dilworth St, Glendive, MT 59330 | 2015-06-24 |
| 1598009441 | Kayli Carmen Christophel | Physician Assistant | 107 Dilworth St, Glendive, MT 59330-2053 | 2012-11-15 |
| 1386990869 | Christopher Henderson | Nurse Practitioner | 107 Dilworth St, Glendive, MT 59330-2053 | 2012-08-02 |
| 1841510104 | Elizabeth Rouene Brown | Obstetrics & Gynecology | 107 Dilworth St, Glendive, MT 59330-2053 | 2010-06-09 |
| 1649433293 | Chrystal Lynn Potter | Internal Medicine | 107 Dilworth St, Glendive, MT 59330-2053 | 2008-07-03 |
| 1538293311 | Gabert Medical Services,inc | Durable Medical Equipment & Medical Supplies | 107 Dilworth St, Glendive, MT 59330-2053 | 2007-03-15 |
| 1457424244 | Charlene Pontoriero | Nurse Practitioner | 107 Dilworth St, Glendive, MT 59330-2053 | 2006-11-17 |
| 1699845461 | Gabert Medical Services, Inc | Pharmacy | 107 Dilworth St, Glendive, MT 59330-2053 | 2006-11-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003312224 | Ashley Grammens | Pharmacist | 307 Harmon Street, Glendive, MT 59330 | 2018-04-05 |
| 1154651016 | Debra Linn | Speech-Language Pathologist | 14 Big Sky Drive, Glendive, MT 59330 | 2009-12-28 |
| 1790293116 | Jessica Marie Domire | Nurse Practitioner | 202 Prospect Dr, Glendive, MT 59330 | 2018-01-19 |
| 1891938882 | Monica M Melchior | Social Worker | 807 Clark Ave, Glendive, MT 59330-1400 | 2009-04-07 |
| 1275593410 | Ft Reynolds | Pharmacy | 1014 W Bell St, Glendive, MT 59330-1502 | 2006-03-23 |
| 1346296266 | Albertsons LLC | Durable Medical Equipment & Medical Supplies | 307 Harmon St, Glendive, MT 59330-1510 | 2006-05-25 |
| 1275870909 | Steve Knoop | Pharmacist | 307 Harmon St, Glendive, MT 59330-1510 | 2013-01-15 |
| 1972030708 | Calkins Dental Office, LLC | Clinic/Center | 116 N Meade Ave, Glendive, MT 59330-1604 | 2017-05-11 |
| 1598177115 | Matthew Don Calkins | Dentist | 116 N Meade Ave, Glendive, MT 59330-1604 | 2014-06-02 |
| 1770831539 | Coburn Dental Office LLC | Clinic/Center | 116 N Meade Ave, Glendive, MT 59330-1604 | 2012-08-27 |
| Find all providers in zip 59330 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386990869 | Christopher Henderson | Nurse Practitioner | 107 Dilworth St, Glendive, MT 59330-2053 | 2012-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053940791 | Christina Louise Borst | Nurse Practitioner | 124 Main Ave N, Choteau, MT 59422-9410 | 2020-04-04 |
| 1073142717 | Tommie L Perusich, PC | Nurse Practitioner | 209 S Montana St Ste B3, Butte, MT 59701-1645 | 2020-04-04 |
| 1043845142 | Samuel R Nave | Nurse Practitioner | 211 Flathead Ave, Bozeman, MT 59718-6339 | 2020-03-09 |
| 1194364091 | Tommie Lynn Perusich | Nurse Practitioner | 1120 Cedar St., Missoula, MT 59802 | 2019-12-26 |
| 1386288694 | David Charles Jansch | Nurse Practitioner | 400 Conley Lake Rd, Deer Lodge, MT 59722-8708 | 2019-10-30 |
| 1255992129 | Huston Psychiatric Services LLC | Nurse Practitioner | 1806 11th Ave, Helena, MT 59601-4768 | 2019-06-21 |
| 1235799032 | Jenna Lynn Belobraidic Kuru | Nurse Practitioner | 3131 Oliver St, Bozeman, MT 59718-6066 | 2019-06-14 |
| 1467016683 | Lovell Mental Health | Nurse Practitioner | 841 E Center St, Dillon, MT 59725-3211 | 2019-04-23 |
| 1023586377 | Eleanor Stacey Combs | Nurse Practitioner | 101 Ponderosa Dr, Butte, MT 59701-7318 | 2018-11-05 |
| 1982103446 | Traci Raines Aprn Pllc | Nurse Practitioner | 120 Marillyn Dr, Great Falls, MT 59405 | 2018-02-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.