Provider Demographics
NPI:1063878189
Name:JOHNSON, LORI ANN (FNP)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
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 1:1806 QUINCY ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-4206
Mailing Address - Country:US
Mailing Address - Phone:806-549-5008
Mailing Address - Fax:
Practice Address - Street 1:1806 QUINCY ST
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-4206
Practice Address - Country:US
Practice Address - Phone:806-288-7891
Practice Address - Fax:806-288-7920
Is Sole Proprietor?:No
Enumeration Date:2016-01-05
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028307363LF0000X
MDAC004392363LF0000X
TX800843363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily