MEDICARE: MISS ARIEL Z 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	:	1942069505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ARIEL Z JOHNSON

Provider Business Mailing Address
First Line	:	3777 ROBB AVE APT 56
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-4536
Country	:	US
Telephone Number	:	513-551-7515
Fax Number	:

Provider Business Practice Location Address
First Line	:	3777 ROBB AVE APT 56
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-4536
Country	:	US
Telephone Number	:	513-551-7515
Fax Number	:

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

Provider Enumeration Date	:	03/18/2024
Last Update Date	:	03/18/2024

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