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NPI Code Detail

MEDICARE: MRS. LAURY KAY JOHNSON R.N.

MEDICARE: MRS. LAURY KAY JOHNSON R.N.
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
1163WS0200XSchool Registered NurseRN065384AZ

General Provider Information

NPI Number : 1598954935
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURY KAY JOHNSON R.N.
Provider Business Mailing Address
First Line : 2610 W 21ST ST
Second Line :
City : YUMA
State : AZ
Zip : 85364-6008
Country : US
Telephone Number : 928-343-2178
Fax Number :
Provider Business Practice Location Address
First Line : 44150 W MARICOPA CASA GRANDE HWY
Second Line :
City : MARICOPA
State : AZ
Zip : 85138-5900
Country : US
Telephone Number : 520-568-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2007
Last Update Date : 08/20/2010

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