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NPI Code Detail

MEDICARE: ASHLEY JOHNSON

MEDICARE: ASHLEY JOHNSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist1636NE

General Provider Information

NPI Number : 1245602978
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY JOHNSON
Provider Business Mailing Address
First Line : 109 N ENGDAHL AVE
Second Line :
City : OAKLAND
State : NE
Zip : 68045-1409
Country : US
Telephone Number : 402-380-1221
Fax Number :
Provider Business Practice Location Address
First Line : 20650 GLENN ST
Second Line :
City : ELKHORN
State : NE
Zip : 68022-2324
Country : US
Telephone Number : 402-380-1221
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2015
Last Update Date : 10/21/2015

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Directions to “ ASHLEY JOHNSON ” Practice Location

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