MEDICARE: SHEREE N JOHNSON-STREET NP

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	771216	TX
2	363L00000X	Nurse Practitioner	AP122817	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AP122817	OTHER	TX	TEXAS NURSING BOARD

General Provider Information

NPI Number	:	1730426859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEREE N JOHNSON-STREET NP

Provider Business Mailing Address
First Line	:	3026 LEMMINGHAM DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388
Country	:	US
Telephone Number	:	832-444-8418
Fax Number	:

Provider Business Practice Location Address
First Line	:	3026 LEMMINGHAM DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-2570
Country	:	US
Telephone Number	:	832-444-8418
Fax Number	:

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

Provider Enumeration Date	:	01/09/2013
Last Update Date	:	07/21/2022

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