Sadie Elizabeth Johnson

Individual provider Active NPI Case Manager/Care Coordinator · Walnut Ridge, AR

NPI 1013409960 · NPPES record last updated Jun 5, 2018

Key facts

NPI
1013409960
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
102 South Larkspur
Walnut Ridge, AR 72476
Phone
(870) 886-7924
Fax
(870) 886-7968
NPI assigned
Jun 5, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

102 South Larkspur
Walnut Ridge, AR 72476

Mailing address

2707 Browns LN
Jonesboro, AR 72401-7213
Phone (870) 972-4939

Other providers in Walnut Ridge, AR

All providers in Walnut Ridge, AR · Case Manager/Care Coordinator in Arkansas

Sources for this page

Verify at the official NPI Registry.