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Individual

SHAWNA JOHNSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
7712 CALLE PARAISO NE, ALBUQUERQUE, NM 87113-1273
(505) 727-8000
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
R52938
NM
363LF0000X
Family Nurse Practitioner
Primary
CNP-03115
NM

Other

Enumeration date
05/11/2016
Last updated
02/07/2018
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