Provider Demographics
NPI:1346053360
Name:JOHNSON, AUBRE LYNN
Entity type:Individual
Prefix:MS
First Name:AUBRE
Middle Name:LYNN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2218 S EAGLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-5018
Mailing Address - Country:US
Mailing Address - Phone:435-531-0702
Mailing Address - Fax:
Practice Address - Street 1:2218 S EAGLE RIDGE DR
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-5018
Practice Address - Country:US
Practice Address - Phone:435-531-0702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program