Provider Demographics
NPI:1891020889
Name:JOHNSON, ROBIN RENEE (ARNP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:RENEE
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 1:8325 NW EXPRESSWAY
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-6006
Mailing Address - Country:US
Mailing Address - Phone:405-749-7099
Mailing Address - Fax:405-773-9437
Practice Address - Street 1:8325 NW EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-6006
Practice Address - Country:US
Practice Address - Phone:405-749-7099
Practice Address - Fax:405-773-9437
Is Sole Proprietor?:No
Enumeration Date:2009-10-08
Last Update Date:2014-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0070963163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200265450AMedicaid