MEDICARE: DR. LEANN 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	772	CO

General Provider Information

NPI Number	:	1790167120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEANN JOHNSON AU.D.

Provider Business Mailing Address
First Line	:	3661 HIGHWAY 231
Second Line	:
City	:	ERIN
State	:	TN
Zip	:	37061
Country	:	US
Telephone Number	:	970-673-5182
Fax Number	:

Provider Business Practice Location Address
First Line	:	3661 HIGHWAY 231
Second Line	:
City	:	ERIN
State	:	TN
Zip	:	37061
Country	:	US
Telephone Number	:	970-673-5182
Fax Number	:

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

Provider Enumeration Date	:	06/22/2015
Last Update Date	:	03/04/2026

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