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Danienne Rae Johnson

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

1024 E Frye Rd Unit 1100, Phoenix, AZ 85048-1994

PECOS Enrollment

This provider is enrolled in PECOS as DANIENNE JOHNSON.

Based on the most recent information from CMS, provider Danienne Rae Johnson is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 9:43 AM.

Profile Details

Provider ID
1841915063
Provider Type
Individual
Full Name
Johnson, Danienne Rae
Title
Ms.
Credential
FNP-C

Gender
Female
Sole Proprietor
Yes
Enumeration Date
10/10/2022
Last Updated
12/14/2025

Contact Information

Practice Location

1024 E Frye Rd Unit 1100, Phoenix, AZ 85048-1994

(602) 579-4743

Unlisted Fax

Mailing Location

1024 E Frye Rd Unit 1100, Phoenix, AZ 85048-1994

(602) 579-4743

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 281092 Arizona

Provider Identifiers

ID	Description	Issuer
ID 281092	Description Other	Issuer AZ STATE BOARD OF NURSING Arizona

Danienne Rae Johnson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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