Provider Demographics
NPI:1811917271
Name:JOHNSON, SARAH J (FNP)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:J
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2376 N 400 E STE 204
Mailing Address - Street 2:NORTHPOINTE MEDICAL PARK
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-3413
Mailing Address - Country:US
Mailing Address - Phone:435-882-1433
Mailing Address - Fax:435-882-1431
Practice Address - Street 1:2376 N 400 E STE 204
Practice Address - Street 2:NORTHPOINTE MEDICAL PARK
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-3413
Practice Address - Country:US
Practice Address - Phone:435-882-1433
Practice Address - Fax:435-882-1431
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT218332-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT61707OtherPEHP
UTQM0000049663OtherALTIUS
UT02183324400001OtherBLUE CROSS
UT17-00212OtherUNITED HEALTHCARE
UT02183324400001OtherBLUE CROSS
UT61707OtherPEHP