Individual provider Active NPI

Stephanie Annette Johnson, LPN

  • Licensed Practical Nurse
  • Jonesboro, AR
National Provider Identifier
1962311985
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
L032794 Issued in AR
Practice address
3901 Aggie Rd
Jonesboro, AR 72405-9319
Phone
(870) 336-4700
Fax
(870) 336-4705
NPI assigned
Sep 4, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164W00000X L032794 AR Primary

Addresses

Primary practice location

3901 Aggie Rd
Jonesboro, AR 72405-9319

Mailing address

3901 Aggie Rd
Jonesboro, AR 72405-9319
Phone (870) 336-4700

Medicare participation

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1788480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1962311985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 AGGIE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724059319",
            "telephone_number": "870-336-4700",
            "fax_number": "870-336-4705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 AGGIE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724059319",
            "telephone_number": "870-336-4700",
            "fax_number": "870-336-4705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STEPHANIE",
        "middle_name": "ANNETTE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-04",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "AR",
            "license": "L032794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.