Johnson, Shannon L

Johnson, Shannon L is an individual health care provider with primary practice located at 1600 Sw 119Th St , Oklahoma City OK 73170-4908. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Johnson, Shannon L can be contacted via phone (405) 425-8100.

Contact Information

Primary practice address
1600 Sw 119Th St Oklahoma City OK 73170-4908
Phone: (405) 425-8100
Fax: (405) 425-8109
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 60090 Oklahoma
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 60090 Oklahoma

Profile Details

NPI number 1639166499
LBN Legal business name Johnson, Shannon L
Credentials CNP, APRN, CNS-RX
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2005
Last updated Feb 5th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639166499 NPPES
Oklahoma MEDICAID 200030250A

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