Individual
SHAVAUN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
21168 E OCOTILLO RD # 1045, QUEEN CREEK, AZ 85142-8175
(623) 265-6220
(866) 491-7389
Mailing address
21168 E OCOTILLO RD # 1045, QUEEN CREEK, AZ 85142-8175
(623) 265-6220
(866) 491-7389
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2024022030
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
251493
AZ
Other
Enumeration date
12/18/2020
Last updated
12/28/2025
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