# ALAN D JOHNSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1578090320
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171W00000X | Contractor | — | — | Yes |
| 172V00000X | Community Health Worker | — | — | — |

## Other

- **Enumeration date:** 05/11/2017
- **Last updated:** 10/23/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 106402907 | — | WY |
| 05 | — | 106402908 | — | WY |