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General NPI Number Information
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NPI Number | 1023783933
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Entity Type | Individual
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Provider Name | DEBRA ANN JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 08/12/2021
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 42 SATINWOOD LN
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City | BRIARCLIFF
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State | NY
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Zip | 10510-2300
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Country | US
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Telephone | 914-762-9363
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Fax |
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Provider Business Mailing Address
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Address Line | 42 SATINWOOD LN
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City | BRIARCLIFF
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State | NY
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Zip | 10510-2300
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Country | US
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Telephone | 914-762-9363
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 165506
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License Number State | NY
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