MEDICARE: LISA MARIE 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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1821880899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA MARIE JOHNSON

Provider Business Mailing Address
First Line	:	2720 QUEEN CITY AVE APT 11
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-2633
Country	:	US
Telephone Number	:	513-264-3870
Fax Number	:

Provider Business Practice Location Address
First Line	:	2041 EARLWOOD CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45238-1803
Country	:	US
Telephone Number	:	513-264-3870
Fax Number	:

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

Provider Enumeration Date	:	05/19/2025
Last Update Date	:	05/19/2025

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Directions to “ LISA MARIE JOHNSON ” Practice Location

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