Provider Demographics
NPI:1609576867
Name:JOHNSON, SHEILA RENEE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:RENEE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 GREENWAY CENTER DRIVE
Mailing Address - Street 2:SUITE 620
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770
Mailing Address - Country:US
Mailing Address - Phone:301-715-3744
Mailing Address - Fax:301-477-3525
Practice Address - Street 1:7501 GREENWAY CENTER DRIVE
Practice Address - Street 2:SUITE 620
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770
Practice Address - Country:US
Practice Address - Phone:301-715-3744
Practice Address - Fax:301-477-3525
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR157992363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner