Individual
SANDRA LYNN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
401 NW H ST, STIGLER, OK 74462-1625
(918) 967-5032
(918) 967-5032
Mailing address
401 NW H ST, STIGLER, OK 74462-1625
(918) 967-5032
(918) 967-5032
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1293
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200130700A
—
OK
Enumeration date
08/22/2006
Last updated
08/08/2008
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