Organization
LAURA L. JOHNSON, N.P., P.C.
Active
Other names
Crater Lake Medical South
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA LYNN JOHNSON NP-C (NURSE PRACTITIONER)
(541) 890-8826
Entity
Organization
Contact information
Practice address
21990 HIGHWAY 62, SHADY COVE, OR 97539-9717
(541) 878-2022
(541) 878-1498
Mailing address
PO BOX 508, SHADY COVE, OR 97539-0508
(541) 878-2022
(541) 878-1498
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201050002NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500616623
—
OR
Enumeration date
02/28/2018
Last updated
06/25/2024
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