Healthcare Provider Details

I. General information

NPI: 1851879423
Provider Name (Legal Business Name): NATASHA C JOHNSON MS, CNIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2018
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 459
PRAIRIEVILLE LA
70769-0459
US

IV. Provider business mailing address

2150 TOWN SQUARE PL STE 290
SUGAR LAND TX
77479-1643
US

V. Phone/Fax

Practice location:
  • Phone: 225-239-2301
  • Fax: 225-341-8526
Mailing address:
  • Phone: 281-768-6730
  • Fax: 281-768-6766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: