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General NPI Number Information
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NPI Number | 1548176324
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Entity Type | Individual
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Provider Name | SHANNON A JOHNSON RN
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Gender | Female
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Dates
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Enumeration Date | 08/20/2026
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Last Update Date | 08/20/2026
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Provider Practice Location Address
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Address Line | 419 COLES LDG
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City | LA PLACE
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State | LA
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Zip | 70068-2956
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Country | US
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Telephone | 504-231-5471
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Fax |
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Provider Business Mailing Address
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Address Line | 419 COLES LDG
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City | LA PLACE
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State | LA
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Zip | 70068-2956
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Country | US
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Telephone | 504-231-5471
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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 | 163WD1100X
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Taxonomy Name | Peritoneal Dialysis Registered Nurse
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License Number | RN153126
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License Number State | LA
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