Provider Demographics
NPI:1801039672
Name:DAWNA HERRON JOHNSON, PC
Entity Type:Organization
Organization Name:DAWNA HERRON JOHNSON, PC
Other - Org Name:OILTON FAMILY HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAWNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HERRON-JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, ARNP PC
Authorized Official - Phone:918-865-7936
Mailing Address - Street 1:PO BOX 520
Mailing Address - Street 2:607 SOUTH A AVENUE
Mailing Address - City:OILTON
Mailing Address - State:OK
Mailing Address - Zip Code:74052-0520
Mailing Address - Country:US
Mailing Address - Phone:918-862-3700
Mailing Address - Fax:918-862-3703
Practice Address - Street 1:607 SOUTH A AVENUE
Practice Address - Street 2:
Practice Address - City:OILTON
Practice Address - State:OK
Practice Address - Zip Code:74052-0520
Practice Address - Country:US
Practice Address - Phone:918-862-3700
Practice Address - Fax:918-862-3703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0062363261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1578518312OtherNATIONAL PROVIDER IDENTIFIER
OK100850400AMedicaid
OK30487OtherOKLAHOMA STATE BUREAU OF NARCOTICS AND DANGEROUS DRUGS CONTROL
OKR0062363OtherOKLAHOMA BOARD OF NURSING
OKF0802259OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS
OKF0802259OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS
OK30487OtherOKLAHOMA STATE BUREAU OF NARCOTICS AND DANGEROUS DRUGS CONTROL
OK100850400AMedicaid