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Individual

LAURA LYNN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1619 NW HAWTHORNE AVE STE 204, GRANTS PASS, OR 97526
(541) 916-8530
(541) 916-8533
Mailing address
PO BOX 550, EAGLE POINT, OR 97524-0550
(541) 830-0333
(541) 830-0863

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201050002NP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500616623
OR
Enumeration date
01/06/2010
Last updated
07/03/2018
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