Provider Demographics
NPI:1588949465
Name:JOHNSON, SARAH MCKINLEY (ACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MCKINLEY
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 HURRICANE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-6303
Mailing Address - Country:US
Mailing Address - Phone:423-242-5227
Mailing Address - Fax:
Practice Address - Street 1:1848 ROSSVILLE AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408-1932
Practice Address - Country:US
Practice Address - Phone:422-551-6555
Practice Address - Fax:256-304-5456
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN218083163W00000X, 363LA2100X
TN178617163W00000X
TN16718363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care