Individual
SOPHIE RAE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1400 S DOBSON RD, MESA, AZ 85202-4707
(480) 412-3000
Mailing address
48 RIVER ST, JACKSON, MN 56143-3369
(507) 840-0788
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9973
AZ
363A00000X
Physician Assistant
—
—
Other
Enumeration date
09/21/2023
Last updated
11/29/2023
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