Provider Demographics
NPI:1669694469
Name:JOHNSON, ROSIE L (WHCNP)
Entity type:Individual
Prefix:
First Name:ROSIE
Middle Name:L
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4201 BROOK SPRING DR
Practice Address - Street 2:OAKWEST WOMEN'S HEALTH CENTER
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224-4938
Practice Address - Country:US
Practice Address - Phone:214-266-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX243922363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175018402Medicaid
TX175018406Medicaid
TX175018410Medicaid
TX175018405Medicaid
TX175018411Medicaid
TX175018403Medicaid
TX175018408Medicaid
TX175018409Medicaid
TX8Y1866OtherBLUE CROSS BLUE SHIELD
TX175018407Medicaid
TX175018404Medicaid