Provider Demographics
NPI:1861294134
Name:JOHNSON, SARAH SUE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:SUE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 113
Mailing Address - Street 2:
Mailing Address - City:LINDSAY
Mailing Address - State:NE
Mailing Address - Zip Code:68644-0113
Mailing Address - Country:US
Mailing Address - Phone:402-992-0257
Mailing Address - Fax:402-992-0257
Practice Address - Street 1:409 CHERRI O RD
Practice Address - Street 2:
Practice Address - City:LINDSAY
Practice Address - State:NE
Practice Address - Zip Code:68644-4622
Practice Address - Country:US
Practice Address - Phone:409-922-0257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty