Individual
LAURA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNPC-AG
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001
(928) 773-0003
(928) 773-1170
Mailing address
5 W OAK AVE, FLAGSTAFF, AZ 86001-1471
(480) 620-1711
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
229669
AZ
363LA2100X
Acute Care Nurse Practitioner
RN261695
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
573244
—
AZ
Enumeration date
04/05/2017
Last updated
05/19/2023
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