Healthcare Provider Details

I. General information

NPI: 1306476569
Provider Name (Legal Business Name): MEAGAN E. JOHNSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2020
Last Update Date: 04/21/2022
Certification Date: 04/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 SW 34TH CIRCLE SUITE 101
OCALA FL
34474-3391
US

IV. Provider business mailing address

4881 NW 8TH AVE SUITE 2
GAINESVILLE FL
32605-5482
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-3110
  • Fax: 352-732-0028
Mailing address:
  • Phone: 352-416-1082
  • Fax: 352-373-6144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11003698
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: