Basic Information
| Provider Information | |||||||||
| NPI: | 1275690265 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOHNSON SAYER | ||||||||
| FirstName: | RENEE | ||||||||
| MiddleName: | MICHELLE | ||||||||
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| Credential: | APRN | ||||||||
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| OtherLastName: | JOHNSON | ||||||||
| OtherFirstName: | RENEE | ||||||||
| OtherMiddleName: | MICHELLE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 7261 MERCY RD | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681242311 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1721 COLFAX ST | ||||||||
| Address2: | |||||||||
| City: | SCHUYLER | ||||||||
| State: | NE | ||||||||
| PostalCode: | 686611400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023523745 | ||||||||
| FaxNumber: | 4023528750 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2007 | ||||||||
| LastUpdateDate: | 11/05/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 110385 | NE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.