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NPI Code Detail

MEDICARE: MISS SHASA RAE JOHNSON

MEDICARE: MISS SHASA RAE 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
1376K00000XNurse's Aide401616610214OH

General Provider Information

NPI Number : 1215625595
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS SHASA RAE JOHNSON
Provider Business Mailing Address
First Line : 551 CUYAHOGA ST
Second Line :
City : AKRON
State : OH
Zip : 44310-1904
Country : US
Telephone Number : 330-515-0080
Fax Number :
Provider Business Practice Location Address
First Line : 551 CUYAHOGA ST
Second Line :
City : AKRON
State : OH
Zip : 44310-1904
Country : US
Telephone Number : 330-515-0080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2023
Last Update Date : 04/25/2023

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Directions to “ MISS SHASA RAE JOHNSON ” Practice Location

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