Mrs Wanda Lee Johnson, RN is a
Registered Nurse based in Black Jack, Missouri. Mrs Wanda Lee Johnson is licensed to practice in Missouri (license number 141209) and her current practice location is
4866 Persimmon Bend Ln, Black Jack, Missouri. She can be reached at her office (for appointments etc.) via phone at
(314) 409-3758.
NPI number for Mrs Wanda Lee Johnson is 1598160509 and her current mailing address is 4866 Persimmon Bend Ln, Black Jack, Missouri. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1598160509.
Provider's Profile
Full Name | Mrs Wanda Lee Johnson |
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Gender | Female |
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Speciality | Registered Nurse |
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Location | 4866 Persimmon Bend Ln, Black Jack, Missouri |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1598160509
- Provider Enumeration Date: 11/03/2014
- Last Update Date: 11/03/2014
Medical Identifiers
Medical identifiers for Mrs Wanda Lee Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1598160509 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | 141209 (Missouri) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Wanda Lee Johnson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Wanda Lee Johnson, RN 4866 Persimmon Bend Ln, Black Jack, MO 63033-4568 Ph: (314) 409-3758 | Mrs Wanda Lee Johnson, RN 4866 Persimmon Bend Ln, Black Jack, MO 63033-4568 Ph: (314) 409-3758 |
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