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NPI Code Detail

MEDICARE: SHARDAE DARLENE JOHNSON

MEDICARE:   SHARDAE DARLENE 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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1811550577
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARDAE DARLENE JOHNSON
Provider Business Mailing Address
First Line : 12 E EXCHANGE ST
Second Line :
City : AKRON
State : OH
Zip : 44308-1519
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3305 E 132ND ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44120-3938
Country : US
Telephone Number : 216-496-3260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2019
Last Update Date : 04/18/2019

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Directions to “ SHARDAE DARLENE JOHNSON ” Practice Location

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