Individual
SHAUNA R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC, PMHNP-BC
Contact information
Practice address
10 PATEWOOD DR STE 130, GREENVILLE, SC 29615-6317
(864) 455-8988
(864) 455-4540
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
18232
SC
363LF0000X
Family Nurse Practitioner
ARNP9455780
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
ARNP9455780
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
Enumeration date
08/11/2009
Last updated
02/05/2024
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