Individual provider · NPI-1

Kellie A. Johnson, RN, CDOE

Registered Nurse, Diabetes Educator · Warwick, RI

NPI number1871351635
StatusActive
Last updated in NPPESMar 7, 2024

Details

NPI
1871351635
Entity type
Individual (NPI-1)
Name
Kellie A. Johnson
Credential
RN, CDOE
Sex
Female
Sole proprietor
No
Enumeration date
Mar 7, 2024
Certification date
Mar 7, 2024
Last updated
Mar 7, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WD0400X Registered Nurse, Diabetes EducatorRN35726RIYes

Practice location

1 Coastway Blvd
Warwick, RI 02886-0006

Phone 401-463-8178

Mailing address

375 Allens Ave
Providence, RI 02905-5010

Phone 401-444-0400

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