| Doctor Name: | LAURA LYNN JOHNSON |
| NPI Number: | 1023348430 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 201050002NP |
| Business Practice Address: | 275 Loto St Eagle Point, OR - 975249517 |
| Business Phone Number: | 5418300333 |
| Business Fax Number: | 5418300863 |
| Mailing Address: | Po Box 550, EAGLE POINT |
| State: | OR |
| Postal Code: | 975240550 |
| Phone Number: | 5418300333 |
| Fax Number: | 5418300863 |
| NPI Enumeration Date: | 01/06/2010 |
| NPI Last Update Date: | 01/06/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 201050002NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |