Individual
SHANNON KATHLEEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1210 W BRAKER LN, AUSTIN, TX 78758-3801
(512) 978-9300
(512) 901-9737
Mailing address
1210 W BRAKER LN, AUSTIN, TX 78758-3801
(512) 978-9300
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
1329
CA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
1329
CA
367A00000X
Advanced Practice Midwife
Primary
1046931
TX
Other
Enumeration date
05/26/2006
Last updated
12/08/2021
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