=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861294134
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARAH SUE JOHNSON
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2025
-----------------------------------------------------
Last Update Date | 03/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 409 CHERRI O RD
-----------------------------------------------------
City | LINDSAY
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68644-4622
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 409-922-0257
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 113
-----------------------------------------------------
City | LINDSAY
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68644-0113
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-992-0257
-----------------------------------------------------
Fax | 402-992-0257
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 372600000X
-----------------------------------------------------
Taxonomy Name | Adult Companion
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------