Healthcare Provider Details

I. General information

NPI: 1942951470
Provider Name (Legal Business Name): ROBIN E JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2022
Last Update Date: 01/17/2022
Certification Date: 01/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5295 EAST KNOLL CT. ATP 823
CINCINNATI OH
45239
US

IV. Provider business mailing address

5295 EAST KNOLL CT. ATP 823
CINCINNATI OH
45239
US

V. Phone/Fax

Practice location:
  • Phone: 513-484-2350
  • Fax:
Mailing address:
  • Phone: 513-484-2350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: