Healthcare Provider Details

I. General information

NPI: 1629415500
Provider Name (Legal Business Name): TANYA MARIE JOHNSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2013
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 SW 1ST AVE UNIT 1179
OCALA FL
34478-7748
US

IV. Provider business mailing address

400 SW 1ST AVE UNIT 1179
OCALA FL
34478-7748
US

V. Phone/Fax

Practice location:
  • Phone: 352-421-5694
  • Fax: 352-421-5226
Mailing address:
  • Phone: 352-421-5694
  • Fax: 352-421-5226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9213321
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberAPRN9213321
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: