| Doctor Name: | MR. DALE ALLEN JOHNSON |
| NPI Number: | 1104856533 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ARNP-C |
| License Number: | 45205 |
| Business Practice Address: | 301 S Washington Coldwater, KS - 67029 |
| Business Phone Number: | 6205822136 |
| Business Fax Number: | 6205822515 |
| Mailing Address: | Hc 64 Box 51a, COLDWATER |
| State: | KS |
| Postal Code: | 670299340 |
| Phone Number: | 6205822518 |
| Fax Number: | |
| NPI Enumeration Date: | 07/03/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 45205 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |