MEDICARE: DR. SARAH CORRINE JOHNSON AU.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	403-A	SD

General Provider Information

NPI Number	:	1336492644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH CORRINE JOHNSON AU.D.

Provider Business Mailing Address
First Line	:	4904 E ROSA PARKS PL
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57110-4041
Country	:	US
Telephone Number	:	605-521-8750
Fax Number	:

Provider Business Practice Location Address
First Line	:	4904 E ROSA PARKS PL
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57110-4041
Country	:	US
Telephone Number	:	605-521-8750
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2012
Last Update Date	:	08/25/2023

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