Individual
JAMIE ALLAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2601 FONTAINE PL, EL RENO, OK 73036-5853
(405) 313-8364
Mailing address
2601 FONTAINE PL, EL RENO, OK 73036-5853
(405) 313-8364
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L36095
OK
Other
Enumeration date
04/03/2026
Last updated
04/03/2026
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