Individual
SUSAN L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2200 S 40TH ST, STE 104, LINCOLN, NE 68506-2407
(402) 483-6000
(402) 483-6106
Mailing address
8055 O ST, STE 300, LINCOLN, NE 68510-2580
(402) 421-0896
(402) 421-0945
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16056
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-00145
UHC
NE
01
—
1208
MIDLAND'S CHOICE
NE
01
—
35833
BCBS
NE
05
—
470780857 32
—
NE
Enumeration date
08/03/2006
Last updated
07/09/2007
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