Healthcare Provider Details

I. General information

NPI: 1942379557
Provider Name (Legal Business Name): JANNE L JOHNSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 12/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 W CEDAR LOOP
CHEROKEE IA
51012-1566
US

IV. Provider business mailing address

1402 E CRAIG DR
CHEROKEE IA
51012-1106
US

V. Phone/Fax

Practice location:
  • Phone: 712-225-2594
  • Fax: 712-225-6933
Mailing address:
  • Phone: 712-225-2594
  • Fax: 712-225-6933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SM0705X
TaxonomyMedical-Surgical Clinical Nurse Specialist
License NumberS068158
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG068158
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: