Provider Demographics
NPI:1730398504
Name:JOHANSON, SANDRA MCLAUGHLIN (APRN)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:MCLAUGHLIN
Last Name:JOHANSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 OAK PARK DR
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-4615
Mailing Address - Country:US
Mailing Address - Phone:973-267-4888
Mailing Address - Fax:
Practice Address - Street 1:10 OAK PARK DR
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-4615
Practice Address - Country:US
Practice Address - Phone:973-267-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR02994500363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health