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NPI Code Detail

MEDICARE: SHIANE JOHNSON

MEDICARE: SHIANE 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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1083564710
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIANE JOHNSON
Provider Business Mailing Address
First Line : 144 7TH AVE
Second Line :
City : SOUTH CHARLESTON
State : WV
Zip : 25303-1452
Country : US
Telephone Number : 304-744-4081
Fax Number : 304-744-8606
Provider Business Practice Location Address
First Line : 144 7TH AVE
Second Line :
City : SOUTH CHARLESTON
State : WV
Zip : 25303-1452
Country : US
Telephone Number : 304-744-4081
Fax Number : 304-744-8606
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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Directions to “ SHIANE JOHNSON ” Practice Location

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