STEPHANIE R JOHNSON (NPI# 1740557289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740557289 |
| Entity Type | Individual |
| Full Name | STEPHANIE R JOHNSON |
| Other Name | STEPHANIE R MACTAVISH |
| Credential | CRNP |
| Practice Address |
13304 157th Ave Ne Redmond WA 98052-1742 |
| Practice Telephone | 2159086731 |
| Mailing Telephone | 2159086731 |
| Enumeration Date | 2011-11-29 |
| Last Update Date | 2020-10-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
AP60474118 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
AP60474118 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3615 Chestnut Street, Philadelphia, PA 191042612 | 2156622746 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982214466 | Stephanie Suzanne Johnson | Nurse Practitioner | 3304 Tyler Ct, Lexington, KY 40509-1876 | 2020-08-09 |
| 1679108567 | Stephanie Johnson | Licensed Practical Nurse | 72 Norman St, East Orange, NJ 07017-3415 | 2020-03-11 |
| 1427681139 | Stephanie L Johnson | Counselor | 1325 S Colorado Blvd # B-108, Denver, CO 80222-3303 | 2020-02-20 |
| 1558992792 | Stephanie Jo Johnson | Nurse Practitioner | 106 Riggs Blvd, Bardstown, KY 40004-8067 | 2020-01-27 |
| 1487284485 | Stephanie Johnson | Assistant Behavior Analyst | 1641 Topeka Cir, Sparks, NV 89434-8866 | 2020-01-19 |
| 1841844685 | Stephanie Ann Johnson | Student in an Organized Health Care Education/Training Program | Texas Tech University Health Sciences Center, 3600 N. Garfield, Midland, TX 79705 | 2019-07-30 |
| 1902466055 | Stephanie Aull Johnson | Occupational Therapy Assistant | 4611 Hard Scrabble Rd Ste 312, Columbia, SC 29229-8584 | 2019-06-19 |
| 1992268106 | Stephanie Marin Johnson | Counselor | 1611 Railroad St, Dayton, TN 37321-1044 | 2019-04-13 |
| 1710448477 | Stephanie Charisse Johnson | Counselor | 802 Eston St, Camarillo, CA 93010-4810 | 2019-03-26 |
| 1144784265 | Stephanie Dawn-marie Johnson | Midwife | 3 Maybrook St, Dorchester, MA 02121-4116 | 2019-01-23 |
| Street Address |
13304 157TH AVE NE |
| City | REDMOND |
| State | WA |
| Zip Code | 98052-1742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396301255 | Saraa Abdulateef | Dentist | 16150 Ne 85th St., #212, Redmond, WA 98052 | 2019-05-16 |
| 1174186837 | Zeinab Birjandian | Student in an Organized Health Care Education/Training Program | Carilion Roanoke Memorial Hospital, 1906 Belleview Ave, Roanoke, VA 98052 | 2019-04-18 |
| 1023584026 | Washington Dental Corporation, PC | Dentist | 17126 Redmond Way, Redmond, WA 98052 | 2018-10-17 |
| 1275047599 | Simeon P Roth | Pharmacist | 8547 Avondale Road Ne, Redmond, WA 98052 | 2017-11-22 |
| 1427560267 | Rania Abou Shadi | Pharmacy | 8862 161st Avenue Ne, Suite 102, Redmond, WA 98052 | 2017-11-02 |
| 1376068981 | Mark W Debourke | Clinic/Center | 7579 Old Redmond Rd, Apt 6, Redmond, WA 98052 | 2017-08-04 |
| 1740712280 | Hyomi Cho | Dentist | 15165 Ne24 Th St, Redmond, WA 98052 | 2017-04-03 |
| 1871033878 | Redmond Ambulatory Surgery Center, LLC | Clinic/Center | 18100 Ne Union Hill Rd Ste 340, Redmond, WA 98052 | 2017-02-24 |
| 1346797933 | Bridger Griffin | Speech-Language Pathologist | 8301 16st Ave Ne, Redmond, WA 98052 | 2016-09-01 |
| 1508313123 | Austin Schieler | Pharmacist | 14480 Ne 24th Street, Redmond, WA 98052 | 2016-09-01 |
| Find all providers in zip 98052 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730713348 | Terra Ann Mclain | Nurse Practitioner | 2803 Pilot Ln, Yakima, WA 98901-1022 | 2020-02-24 |
| 1437716032 | Julia Yang Chen | Nurse Practitioner | 16831 1st Ave W, Bothell, WA 98012-4961 | 2019-05-20 |
| 1699242651 | Patricia Fay Fitzhugh | Nurse Practitioner | 615 W 16th Ave, Spokane, WA 99203-2130 | 2018-10-29 |
| 1598240657 | Beibei Chen | Nurse Practitioner | 5801 223rd Pl Sw, Mountlake Terrace, WA 98043-3123 | 2018-09-25 |
| 1497203244 | Trina Koudelka | Nurse Practitioner | 3015 Squalicum Pkwy Ste 100, Bellingham, WA 98225-1906 | 2016-09-21 |
| 1255791414 | Quynh-anh Phan | Nurse Practitioner | 801 Sw 150th St Ste 230, Burien, WA 98166-1855 | 2016-03-02 |
| 1467836056 | Horizon Health Foundation | Nurse Practitioner | 123 W. Cascade Way, Spokane, WA 99208 | 2015-07-14 |
| 1578955910 | Esateys Stuchiner | Nurse Practitioner | 19410 Ne 116th St, Brush Prairie, WA 98606-3002 | 2015-02-23 |
| 1619377587 | Phiroce Ishaque, LLC | Nurse Practitioner | 5414 Barnes Ave Nw Ste 1, Seattle, WA 98107-3839 | 2014-08-28 |
| 1700217155 | Elisa Martin | Nurse Practitioner | 6025 Vassar Ave Ne, Seattle, WA 98115-7622 | 2013-12-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.