MEDICARE: LAUREL-ANNE 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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1275460214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREL-ANNE JOHNSON

Provider Business Mailing Address
First Line	:	12852 S 4240 RD
Second Line	:
City	:	CHELSEA
State	:	OK
Zip	:	74016-2131
Country	:	US
Telephone Number	:	918-803-2962
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 MEDICAL PKWY
Second Line	:
City	:	CLAREMORE
State	:	OK
Zip	:	74017-1088
Country	:	US
Telephone Number	:	844-458-2100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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Directions to “ LAUREL-ANNE JOHNSON ” Practice Location

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