Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Desiree L Johnson, PA-C

Individual provider Surgical Physician Assistant · NPI 1174589782

Desiree L Johnson, PA-C is a Surgical Physician Assistant in Fort Campbell, Kentucky. Licensed in Texas. Registered with an NPI since 2006.

Licensed in
TX
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

650 Joel Dr
Fort Campbell, KY 42223-5318
Phone: (270) 798-8727
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA04614 (TX)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA04614 (TX)

Record details

NPI number1174589782
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 22, 2006
Last updated in NPPESJanuary 22, 2024
Certification dateAugust 23, 2023

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