MEDICARE: MICHELLE 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
1	363L00000X	Nurse Practitioner	82503	OK

General Provider Information

NPI Number	:	1912546144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE JOHNSON APRN

Provider Business Mailing Address
First Line	:	1900 NW EXPRESSWAY STE 800
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-1804
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 NW EXPRESSWAY STE 800
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-1804
Country	:	US
Telephone Number	:	405-887-3141
Fax Number	:

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

Provider Enumeration Date	:	01/06/2020
Last Update Date	:	02/26/2026

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