Provider Demographics
NPI:1326373150
Name:JOHNSON, EVAUGHNA J (ARNP)
Entity Type:Individual
Prefix:MS
First Name:EVAUGHNA
Middle Name:J
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 SILVER HILL DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-3316
Mailing Address - Country:US
Mailing Address - Phone:405-557-1200
Mailing Address - Fax:405-557-1977
Practice Address - Street 1:4334 NW EXPRESSWAY
Practice Address - Street 2:SUITE 175
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1578
Practice Address - Country:US
Practice Address - Phone:405-557-1200
Practice Address - Fax:405-557-1977
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-13
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK46156363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health