Individual
ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
15 CLEVELAND STREET, VALLEY STREAM, NY 11580
(212) 677-8666
Mailing address
234 - 19 130 AVENUE, ROSEDALE, NY 11422
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
307365
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
307365
LPN
NY
Enumeration date
10/11/2011
Last updated
10/11/2011
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