Provider Demographics
NPI:1275690265
Name:JOHNSON SAYER, RENEE MICHELLE (APRN)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:MICHELLE
Last Name:JOHNSON SAYER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:MICHELLE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7261 MERCY RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2311
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1721 COLFAX ST
Practice Address - Street 2:
Practice Address - City:SCHUYLER
Practice Address - State:NE
Practice Address - Zip Code:68661-1400
Practice Address - Country:US
Practice Address - Phone:402-352-3745
Practice Address - Fax:402-352-8750
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110385363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE273352Medicare PIN
P20343Medicare UPIN
NE086248Medicare Oscar/Certification