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NPI Code Detail

MEDICARE: JOHNNY ALEX TOLER

MEDICARE:   JOHNNY ALEX TOLER
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
1376K00000XNurse's AideCNA034060NV
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1437760444
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHNNY ALEX TOLER
Provider Business Mailing Address
First Line : 562 TWILIGHT BLUE AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-8227
Country : US
Telephone Number : 323-218-1535
Fax Number :
Provider Business Practice Location Address
First Line : 562 TWILIGHT BLUE AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-8227
Country : US
Telephone Number : 323-218-1535
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2020
Last Update Date : 08/13/2020

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Directions to “ JOHNNY ALEX TOLER ” Practice Location

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