MEDICARE: MISS ARLINDA LOUISE 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	376K00000X	Nurse's Aide	CNA56241	FL

General Provider Information

NPI Number	:	1306027818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ARLINDA LOUISE JOHNSON

Provider Business Mailing Address
First Line	:	3400 TOWNSEND BLVD APT 192
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32277-2748
Country	:	US
Telephone Number	:	904-743-1492
Fax Number	:

Provider Business Practice Location Address
First Line	:	3400 TOWNSEND BLVD APT 192
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32277-2748
Country	:	US
Telephone Number	:	904-743-1492
Fax Number	:

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

Provider Enumeration Date	:	11/27/2007
Last Update Date	:	11/27/2007

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