Healthcare Provider Details

I. General information

NPI: 1609794676
Provider Name (Legal Business Name): PATRICIA ELLEN JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7530 LINDER WAY
GALENA OH
43021-9237
US

IV. Provider business mailing address

7530 LINDER WAY
GALENA OH
43021-9237
US

V. Phone/Fax

Practice location:
  • Phone: 614-207-5168
  • Fax:
Mailing address:
  • Phone: 614-207-5168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number258908
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: