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General NPI Number Information
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NPI Number | 1003434176
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Entity Type | Individual
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Provider Name | SHARONDA SHANISE JOHNSON NURSING ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 07/06/2020
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | 325 E 15TH ST
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City | APOPKA
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State | FL
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Zip | 32703-7114
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Country | US
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Telephone | 321-316-2998
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Fax |
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Provider Business Mailing Address
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Address Line | 1070 MONTGOMERY RD
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-7420
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Country | US
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Telephone | 407-902-1307
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | 124
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State | FL
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