Bryttni Allen Johnson
Individual provider Active NPI Peer Specialist · Wagoner, OK
NPI 1336006113 · NPPES record last updated Jan 12, 2026
Key facts
- NPI
- 1336006113
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- License
- 2610M0801X (OK)
- Practice address
- 109 S Harrill Ave
Wagoner, OK 74467-5317 - Phone
- (918) 485-0242
- NPI assigned
- Jan 5, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2610M0801X | OK | MD | Peer Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 2610M0801X | OK | Yes |
Addresses
Primary practice location
109 S Harrill Ave
Wagoner, OK 74467-5317
Mailing address
109 S Harrill Ave
Wagoner, OK 74467-5317
Phone (918) 485-0242
Other providers in Wagoner, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.