MEDICARE: MRS. TANYA MARIE 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	363LF0000X	Family Nurse Practitioner	APRN9213321	FL
2	261QU0200X	Urgent Care Clinic/Center	APRN9213321	FL

General Provider Information

NPI Number	:	1629415500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TANYA MARIE JOHNSON ARNP

Provider Business Mailing Address
First Line	:	400 SW 1ST AVE UNIT 1179
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34478-7748
Country	:	US
Telephone Number	:	352-421-5694
Fax Number	:	352-421-5226

Provider Business Practice Location Address
First Line	:	400 SW 1ST AVE UNIT 1179
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34478-7748
Country	:	US
Telephone Number	:	352-421-5694
Fax Number	:	352-421-5226

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

Provider Enumeration Date	:	05/31/2013
Last Update Date	:	01/05/2026

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