Individual
MS. SAMANTHA LYNN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1 CHILDRENS PL, DIV PED ALLERGY/IMMUNO/PULMO, SAINT LOUIS, MO 63110-1002
(314) 454-2694
(314) 454-2515
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 454-2694
(314) 454-2515
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2021048767
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420107218
—
MO
Enumeration date
09/21/2018
Last updated
04/17/2025
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