Provider Demographics
NPI:1861740821
Name:JOHNSON, SHEILA JEANETTE (MASTERS IN EDUCATION)
Entity type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:JEANETTE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MASTERS IN EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 NE 43RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73111-5615
Mailing Address - Country:US
Mailing Address - Phone:405-255-5781
Mailing Address - Fax:
Practice Address - Street 1:1117 NE 43RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73111-5615
Practice Address - Country:US
Practice Address - Phone:405-255-5781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-24
Last Update Date:2012-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator