Provider Demographics
NPI:1346548344
Name:JOHNSON, NORMA FAYE
Entity Type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:FAYE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 NW 122ND ST
Mailing Address - Street 2:APT 514
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8447
Mailing Address - Country:US
Mailing Address - Phone:405-476-3803
Mailing Address - Fax:
Practice Address - Street 1:6701 BROADWAY EXT
Practice Address - Street 2:SUITE #210
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-8237
Practice Address - Country:US
Practice Address - Phone:405-563-0498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner