MEDICARE: MS. ANNETTE J. JOHNSON ARNP

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	363L00000X	Nurse Practitioner	A086077	IA

General Provider Information

NPI Number	:	1396847331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANNETTE J. JOHNSON ARNP

Provider Business Mailing Address
First Line	:	101 WEST MAIN STREET
Second Line	:	BOX 278
City	:	LIME SPRINGS
State	:	IA
Zip	:	52155-0278
Country	:	US
Telephone Number	:	563-566-2243
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 WEST MAIN STREET
Second Line	:	BOX 278
City	:	LIME SPRINGS
State	:	IA
Zip	:	52155-0278
Country	:	US
Telephone Number	:	563-566-2243
Fax Number	:

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

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	07/09/2007

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