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NPI Code Detail

MEDICARE: LACRECIA SHANAI JOHNSON

MEDICARE:   LACRECIA SHANAI 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 AttendantDC

General Provider Information

NPI Number : 1710419296
Entity Type Code : Individual
Provider Name (Legal Business Name) : LACRECIA SHANAI JOHNSON
Provider Business Mailing Address
First Line : 3323 10TH PLACE SE #T4
Second Line :
City : WASHINGTON, D.C.
State : DC
Zip : 20032-5957
Country : US
Telephone Number : 202-509-4670
Fax Number :
Provider Business Practice Location Address
First Line : 3323 10TH PLACE SE #T4
Second Line :
City : WASHINGTON, D.C.
State : DC
Zip : 20032-5957
Country : US
Telephone Number : 202-509-4670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2017
Last Update Date : 04/03/2017

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Directions to “ LACRECIA SHANAI JOHNSON ” Practice Location

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