Healthcare Provider Details

I. General information

NPI: 1275867509
Provider Name (Legal Business Name): VINOKIA MACHELLE JOHNSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2009
Last Update Date: 10/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 CYPRESS STATION DR APT 710
HOUSTON TX
77090-1527
US

IV. Provider business mailing address

905 CYPRESS STATION DR APT 710
HOUSTON TX
77090-1527
US

V. Phone/Fax

Practice location:
  • Phone: 281-608-6721
  • Fax: 281-893-0691
Mailing address:
  • Phone: 281-608-6721
  • Fax: 281-893-0691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number746304
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: