Provider Demographics
NPI:1245538396
Name:JOHANSON, SARAH WOOD (MSN, ACNP-BC, RNFA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:WOOD
Last Name:JOHANSON
Suffix:
Gender:F
Credentials:MSN, ACNP-BC, RNFA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:C
Other - Last Name:WOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 872042
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99687-2042
Mailing Address - Country:US
Mailing Address - Phone:907-745-9401
Mailing Address - Fax:907-746-2655
Practice Address - Street 1:2490 S WOODWORTH LOOP
Practice Address - Street 2:SUITE 450
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-7410
Practice Address - Country:US
Practice Address - Phone:907-745-9401
Practice Address - Fax:907-746-2655
Is Sole Proprietor?:No
Enumeration Date:2011-03-14
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1457363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care