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Individual
WANDA R JOHNSON
Active
Individual
WANDA R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUDIOLOGIST
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
242
NE
2355A2700X
Audiology Assistant
242
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100249918 00
—
NE
05
—
10025369300
—
NE
05
—
10025369400
—
NE
01
—
36809
BCBS
NE
01
—
37016
BCBS
NE
01
—
P00855060
RAILROAD MEDICARE
NE
Enumeration date
08/03/2006
Last updated
11/01/2010
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