Individual
LYNN COOPER JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
914 N SAN FRANCISCO ST STE D, FLAGSTAFF, AZ 86001-3254
(928) 243-0244
(928) 597-5198
Mailing address
5551 S WHITE MOUNTAIN RD UNIT 2, SHOW LOW, AZ 85901-7449
(928) 985-1495
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
RN168022
AZ
363LF0000X
Family Nurse Practitioner
AP5735
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP11496
AZ
Other
Enumeration date
04/11/2011
Last updated
02/18/2020
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