# MRS. SHANNON LEE JOHNSON

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

## Provider details

- **NPI number:** 1750566790
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 002328 | IA | Yes |
| 363A00000X | Physician Assistant | 085003168 | IL | — |

## Other

- **Enumeration date:** 01/09/2008
- **Last updated:** 10/12/2021