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General NPI Number Information
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NPI Number | 1396961587
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Entity Type | Individual
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Provider Name | MS. YOLANDA GAIL JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 06/27/2021
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Provider Practice Location Address
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Address Line | 400 VIA LUGANO CIR APT 109
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-7165
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Country | US
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Telephone | 561-914-4098
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Fax |
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Provider Business Mailing Address
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Address Line | 2240 W WOOLBRIGHT RD STE 403
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-6367
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Country | US
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Telephone | 561-914-4098
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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 | 364SH0200X
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Taxonomy Name | Home Health Clinical Nurse Specialist
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License Number | RN9372891
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN5157974
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License Number State | FL
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