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Individual

NANCY ANN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
4400 W. 69TH ST., STE. 1500, SIOUX FALLS, SD 57108-8171
(605) 322-5700
(605) 322-5704
Mailing address
4400 W. 69TH ST., STE. 1500, SIOUX FALLS, SD 57108-8171
(605) 322-5700
(605) 322-5704

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
531
SD
103TC0700X
Clinical Psychologist
PY01846
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110056
BLUE SHIELD/BLUE CHOICE
MO
01
332725
HEALTHLINK
MO
05
498837301
MO
01
6151573
UNITED HEALTHCARE
MO
Enumeration date
05/05/2006
Last updated
07/23/2015
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