Individual
MISS CHANNEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP, PMHNP-BC
Contact information
Practice address
1728 S CARSON AVE, TULSA, OK 74119-4610
(918) 932-8266
(918) 932-8244
Mailing address
1728 S CARSON AVE, TULSA, OK 74119-4610
(918) 932-8266
(918) 932-8244
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
R0100572
OK
363LF0000X
Family Nurse Practitioner
100572
OK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R0100572
OK
Other
Enumeration date
06/11/2020
Last updated
12/23/2024
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