Individual
LAURA JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1001 15TH AVE NW, ARDMORE, OK 73401-1810
(580) 223-3737
(580) 226-5679
Mailing address
2916 MCLAINE RD SE, ARDMORE, OK 73401-9239
(580) 226-4301
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0037822
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L0037822
LPN LICENSE #
OK
Enumeration date
04/20/2006
Last updated
07/08/2007
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