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NPI Code Detail

MEDICARE: SARA JANE JOHNSON APRN

MEDICARE: SARA JANE JOHNSON APRN
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
1363LF0000XFamily Nurse Practitioner235105AR

General Provider Information

NPI Number : 1629945886
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA JANE JOHNSON APRN
Provider Business Mailing Address
First Line : 2223 GRANT ST
Second Line :
City : MALVERN
State : AR
Zip : 72104-4700
Country : US
Telephone Number : 501-337-9031
Fax Number :
Provider Business Practice Location Address
First Line : 2223 GRANT ST
Second Line :
City : MALVERN
State : AR
Zip : 72104-4700
Country : US
Telephone Number : 501-337-9031
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2025
Last Update Date : 10/22/2025

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Directions to “ SARA JANE JOHNSON APRN” Practice Location

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