Individual
MRS. SADIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
816 22ND AVE, SUITE 100, KEARNEY, NE 68845
(308) 991-8621
Mailing address
1004 WEST 45TH ST, KEARNEY, NE 68845
(308) 991-8621
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1794
NE
Other
Enumeration date
02/03/2014
Last updated
02/03/2014
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