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NPI Code Detail

MEDICARE: SHERECA JOHNSON

MEDICARE:   SHERECA  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
1376K00000XNurse's Aide401241640511OH

General Provider Information

NPI Number : 1942582093
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHERECA JOHNSON
Provider Business Mailing Address
First Line : 3603 LIMESTONE AVE
Second Line :
City : DAYTON
State : OH
Zip : 45417-4114
Country : US
Telephone Number : 937-469-4573
Fax Number :
Provider Business Practice Location Address
First Line : 3603 LIMESTONE AVE
Second Line :
City : DAYTON
State : OH
Zip : 45417-4114
Country : US
Telephone Number : 937-469-4573
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2011
Last Update Date : 09/14/2011

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Directions to “ SHERECA JOHNSON ” Practice Location

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