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NPI Code Detail

MEDICARE: TANYA M JOHNSON RN

MEDICARE:   TANYA M JOHNSON  RN
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
1163W00000XRegistered Nurse876084NV

General Provider Information

NPI Number : 1679425730
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANYA M JOHNSON RN
Provider Business Mailing Address
First Line : 2701 N DECATUR BLVD APT 2038
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-2963
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3930 HOWARD HUGHES PKWY STE 300
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-0946
Country : US
Telephone Number : 702-560-2192
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2026
Last Update Date : 02/11/2026

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