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Individual
MRS. SHANTA MARIE JOHNSON
Active
Individual
MRS. SHANTA MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCMA
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
18023894
AL
374U00000X
Home Health Aide
000000000
AL
374U00000X
Home Health Aide
18023894
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
824882016
—
AL
Enumeration date
05/29/2018
Last updated
04/30/2024
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