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

Tanja Johnson, FNP

Individual provider Nurse Practitioner · NPI 1447654827

Tanja Johnson, FNP is a Nurse Practitioner in Saint Louis, Missouri. Qualified in 2014, 12 years ago. Practices with Provident Inc, a 19-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Missouri.

Years since qualifying
12
Licensed in
MO
In the registry since
2014
Specialties on file
2
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone: (314) 800-6528
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 2014036364 (MO)
Nurse Practitioner Taxonomy 363L00000X · Licence 2014036364 (MO)

Record details

NPI number1447654827
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedOctober 14, 2014
Last updated in NPPESSeptember 16, 2021
Certification dateSeptember 16, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Provident Inc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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