Individual
NANCY ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
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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