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General NPI Number Information
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NPI Number | 1124589957
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Entity Type | Organization
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Legal Business Name | SHARON A JOHNSON FNP LLC
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 124 W WASHINGTON ST
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City | RENSSELAER
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State | IN
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Zip | 47978-2820
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Country | US
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Telephone | 219-866-8655
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Fax | 219-866-0803
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Provider Business Mailing Address
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Address Line | 124 W WASHINGTON ST
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City | RENSSELAER
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State | IN
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Zip | 47978-2820
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Country | US
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Telephone | 219-866-8655
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Fax | 219-866-0803
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | SAMANTHA LAUREL MORAN
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Credential |
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Telephone | 219-866-4135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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