Provider Demographics
NPI:1093830358
Name:JOHNSON, SARAH ELIZABETH (DC)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELIZABETH
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3085 E RUSSELL RD
Mailing Address - Street 2:STE E
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3473
Mailing Address - Country:US
Mailing Address - Phone:702-433-8333
Mailing Address - Fax:702-433-4632
Practice Address - Street 1:3085 E RUSSELL RD
Practice Address - Street 2:STE E
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3473
Practice Address - Country:US
Practice Address - Phone:702-433-8333
Practice Address - Fax:702-433-4632
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNVB928111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV36496Medicare ID - Type Unspecified
NVU90609Medicare UPIN