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NPI Code Detail

MEDICARE: SHATONA VANETTA JOHNSON

MEDICARE: SHATONA VANETTA JOHNSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistAP117671TX

General Provider Information

NPI Number : 1104064831
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHATONA VANETTA JOHNSON
Provider Business Mailing Address
First Line : 4434 10TH ST
Second Line :
City : BACLIFF
State : TX
Zip : 77518-2217
Country : US
Telephone Number : 281-549-6447
Fax Number :
Provider Business Practice Location Address
First Line : 5323 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75390-7201
Country : US
Telephone Number : 214-648-3111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2009
Last Update Date : 03/06/2026

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Directions to “ SHATONA VANETTA JOHNSON ” Practice Location

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