Healthcare Provider Details
I. General information
NPI: 1053248344
Provider Name (Legal Business Name): LENETTE JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
741 W DAWES AVE
LINCOLN NE
68521-3453
US
IV. Provider business mailing address
741 W DAWES AVE
LINCOLN NE
68521-3453
US
V. Phone/Fax
- Phone: 402-601-5569
- Fax:
- Phone: 402-601-5569
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: