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NPI Code Detail

MEDICARE: EMILY DUNN JOHNSON

MEDICARE: EMILY DUNN 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
1106S00000XBehavior TechnicianFL

General Provider Information

NPI Number : 1447032248
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY DUNN JOHNSON
Provider Business Mailing Address
First Line : 130 BURNETT CT UNIT 109
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32259-6995
Country : US
Telephone Number : 904-652-3435
Fax Number :
Provider Business Practice Location Address
First Line : 12735 GRAN BAY PKWY W STE 204
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32258-4499
Country : US
Telephone Number : 888-557-6421
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2023
Last Update Date : 10/17/2023

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Directions to “ EMILY DUNN JOHNSON ” Practice Location

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