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NPI Code Detail

MEDICARE: STEPHANIE A JOHNSON

MEDICARE: STEPHANIE A JOHNSON
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
1163WG0000XGeneral Practice Registered NurseRN60084453WA

General Provider Information

NPI Number : 1932946274
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE A JOHNSON
Provider Business Mailing Address
First Line : 1506 E RADIO RD
Second Line :
City : ELLENSBURG
State : WA
Zip : 98926-9589
Country : US
Telephone Number : 509-925-8497
Fax Number :
Provider Business Practice Location Address
First Line : 1506 E RADIO RD
Second Line :
City : ELLENSBURG
State : WA
Zip : 98926-9589
Country : US
Telephone Number : 509-925-8497
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2024
Last Update Date : 07/12/2024

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Directions to “ STEPHANIE A JOHNSON ” Practice Location

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