Kelly J. Johnson, PA-C
Physician Assistant · Herrin, IL
UnclaimedPA-CNPI 1235412982
- Primary taxonomy
- 363A00000X
- Enumerated
- 2011-09-20
- Practice location
- Herrin, IL
- Last NPPES update
- 2017-02-23
State licenses
- IL · Physician assistant · LICENSED PHYSICIAN ASSISTANTExpiredthrough 2022
- IL · Practical nurse · LICENSED PRACTICAL NURSEExpiredthrough 2017
- KY · Physician assistant · NPPES self-reportedListed on NPI record
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.