Healthcare Provider Details

I. General information

NPI: 1225154529
Provider Name (Legal Business Name): SHARON MICHELLE SCRANTON-JOHNSTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 11/09/2021
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 S SHIELDS ST STE 6&7
FORT COLLINS CO
80521-3590
US

IV. Provider business mailing address

701 SAN MATEO BLVD NE
ALBUQUERQUE NM
87108-1434
US

V. Phone/Fax

Practice location:
  • Phone: 970-493-0281
  • Fax: 970-493-0729
Mailing address:
  • Phone: 505-265-9511
  • Fax: 505-268-4350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR42099
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPN.0996697-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: