Individual
SHANTAE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-BC
Contact information
Practice address
17520 W GRAND PKWY S, SUGAR LAND, TX 77479-4758
(812) 725-5970
Mailing address
17520 W GRAND PKWY S, SUGAR LAND, TX 77479-4758
(281) 725-5970
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP143150
TX
Other
Enumeration date
05/30/2018
Last updated
09/17/2024
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