MEDICARE: CORRIN J JOHNSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	372500000X	Chore Provider	H13172551	NE

General Provider Information

NPI Number	:	1013805779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORRIN J JOHNSON

Provider Business Mailing Address
First Line	:	2255 36TH AVE
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68601-3033
Country	:	US
Telephone Number	:	402-910-9410
Fax Number	:

Provider Business Practice Location Address
First Line	:	2255 36TH AVE
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68601-3033
Country	:	US
Telephone Number	:	402-910-9410
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2025
Last Update Date	:	06/24/2025

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Directions to “ CORRIN J JOHNSON ” Practice Location

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