Provider Demographics
NPI:1578518312
Name:JOHNSON, DAWNA HERRON (RN, MS, ARNP, CNP)
Entity Type:Individual
Prefix:MS
First Name:DAWNA
Middle Name:HERRON
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RN, MS, ARNP, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4845 S SHERIDAN RD STE 411
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-5751
Mailing Address - Country:US
Mailing Address - Phone:918-641-4531
Mailing Address - Fax:918-641-4717
Practice Address - Street 1:4845 S SHERIDAN RD STE 411
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145
Practice Address - Country:US
Practice Address - Phone:918-641-4531
Practice Address - Fax:918-641-4717
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK62363363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP73849Medicare UPIN