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Individual

SASHA RENAE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
25 PROFESSIONAL PARK DR, CLARKSVILLE, AR 72830
(479) 705-8181
(479) 705-0041
Mailing address
25 PROFESSIONAL PARK DR, CLARKSVILLE, AR 72830-4432
(479) 705-8181
(479) 705-0041

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A006062
AR
363LP2300X
Primary Care Nurse Practitioner
A006062
AR

Other

Enumeration date
01/23/2019
Last updated
04/08/2019
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