Provider Demographics
NPI:1942379557
Name:JOHNSON, JANNE L (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JANNE
Middle Name:L
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 1:1402 E CRAIG DR
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE
Mailing Address - State:IA
Mailing Address - Zip Code:51012-1106
Mailing Address - Country:US
Mailing Address - Phone:712-225-2594
Mailing Address - Fax:712-225-6933
Practice Address - Street 1:1251 W CEDAR LOOP
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:IA
Practice Address - Zip Code:51012-1566
Practice Address - Country:US
Practice Address - Phone:712-225-2594
Practice Address - Fax:712-225-6933
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAS068158364SM0705X
IAG068158363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health