Provider Demographics
NPI:1942861562
Name:JOHNSON, SARAH RUTH (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:RUTH
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6624 FANNIN ST STE 2360
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2315
Mailing Address - Country:US
Mailing Address - Phone:713-794-0500
Mailing Address - Fax:713-794-0946
Practice Address - Street 1:1111 W ADOUE ST
Practice Address - Street 2:
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511-2718
Practice Address - Country:US
Practice Address - Phone:281-824-1480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141261363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily