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NPI Code Detail

MEDICARE: MARILYN MICHELE JOHNSON AA, QMHS,CMS

MEDICARE: MARILYN MICHELE JOHNSON AA, QMHS,CMS
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1720595838
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARILYN MICHELE JOHNSON AA, QMHS,CMS
Provider Business Mailing Address
First Line : 911 SYCAMORE ST
Second Line :
City : CINCINNATI
State : OH
Zip : 45202-1318
Country : US
Telephone Number : 513-651-9300
Fax Number : 513-352-1348
Provider Business Practice Location Address
First Line : 911 SYCAMORE ST
Second Line :
City : CINCINNATI
State : OH
Zip : 45202-1318
Country : US
Telephone Number : 513-651-9300
Fax Number : 513-352-1348
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2018
Last Update Date : 01/10/2018

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