Provider Demographics
NPI:1538672126
Name:JOHNSON, SHARANNA S (DNP, PMHNP-B, FNP-BC)
Entity type:Individual
Prefix:
First Name:SHARANNA
Middle Name:S
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DNP, PMHNP-B, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9998 EAGLE CREEK CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-6333
Mailing Address - Country:US
Mailing Address - Phone:918-752-5472
Mailing Address - Fax:
Practice Address - Street 1:14535 NE BEL RED RD STE 200
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3907
Practice Address - Country:US
Practice Address - Phone:321-343-7008
Practice Address - Fax:321-343-7009
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-06
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ248402363LF0000X, 363LP0808X
IAA163943363LP0808X, 363LF0000X
WAAP61558723363LP0808X, 363LF0000X
WY46550363LF0000X
MDAC006839363LF0000X, 363LP0808X
TN29936363LF0000X
FL9481943363LP0808X
FLAPRN9481943363LF0000X
CA95022245363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily