MEDICARE: BESSIE JOHNSON CNA

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
1	376K00000X	Nurse's Aide	0028845918	GA

General Provider Information

NPI Number	:	1750233565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BESSIE JOHNSON CNA

Provider Business Mailing Address
First Line	:	6049 COVINGTON HWY
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30035-3802
Country	:	US
Telephone Number	:	919-988-3974
Fax Number	:	770-922-8676

Provider Business Practice Location Address
First Line	:	6049 COVINGTON HWY
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30035-3802
Country	:	US
Telephone Number	:	919-988-3974
Fax Number	:	770-922-8676

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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