Individual
SHAUN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
716 STEVENS AVE, PORTLAND, ME 04103-2693
(207) 318-3261
Mailing address
716 STEVENS AVE, PORTLAND, ME 04103-2693
(207) 318-3261
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN69026
ME
Other
Enumeration date
08/06/2025
Last updated
08/06/2025
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