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General NPI Number Information
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NPI Number | 1962043075
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Entity Type | Individual
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Provider Name | SHAYLA ANN JOHNSON CNP
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Gender | Female
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Dates
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Enumeration Date | 10/01/2019
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 5859 W TALAVI BLVD STE 100
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City | GLENDALE
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State | AZ
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Zip | 85306-1870
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Country | US
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Telephone | 602-298-7777
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Fax | 480-889-6865
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Provider Business Mailing Address
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Address Line | 17068 N 50TH PL
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-1465
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Country | US
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Telephone | 605-685-4034
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | CP001644
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License Number State | SD
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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 | 301631
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License Number State | AZ
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