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General NPI Number Information
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NPI Number | 1487454450
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Entity Type | Individual
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Provider Name | SHARIE JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 987 PARALLEL DR STE C
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City | LAKEPORT
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State | CA
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Zip | 95453-5708
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Country | US
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Telephone | 707-262-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 5176 HILL RD E
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City | LAKEPORT
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State | CA
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Zip | 95453-6300
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.530587
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.0039663
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95036599
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License Number State | CA
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