Provider Demographics
NPI:1649333055
Name:JOHNSON, LORENE S (APRN)
Entity type:Individual
Prefix:MS
First Name:LORENE
Middle Name:S
Last Name:JOHNSON
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Gender:F
Credentials:APRN
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Mailing Address - Street 1:12257 BUSINESS PARK DR
Mailing Address - Street 2:BUILDING 6, SUITE 108
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-8126
Mailing Address - Country:US
Mailing Address - Phone:801-816-8622
Mailing Address - Fax:801-816-1456
Practice Address - Street 1:1950 CIRCLE OF HOPE DR
Practice Address - Street 2:HCI, CLINIC E, RM 2381
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84112-5500
Practice Address - Country:US
Practice Address - Phone:801-585-0239
Practice Address - Fax:801-585-0151
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2009-04-09
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Provider Licenses
StateLicense IDTaxonomies
UT286942-4405363LA2100X
UT286942-8900363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care