Healthcare Provider Details

I. General information

NPI: 1326953407
Provider Name (Legal Business Name): ELISABETH ANNE JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40890 WEST HWY 6&34
CAMBRIDGE NE
69022
US

IV. Provider business mailing address

41006 ROAD 719
CAMBRIDGE NE
69022-6566
US

V. Phone/Fax

Practice location:
  • Phone: 308-697-3736
  • Fax:
Mailing address:
  • Phone: 308-340-0843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number2924
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: