Individual
CHARLA JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
95 SOLDIERS PASS RD STE B1, SEDONA, AZ 86336-4712
(928) 204-4900
Mailing address
95 SOLDIERS PASS RD STE B1, SEDONA, AZ 86336-4712
(928) 204-4900
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
234691
AZ
363LG0600X
Gerontology Nurse Practitioner
3234612
FL
Other
Enumeration date
10/24/2006
Last updated
09/26/2022
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