Individual
SHIRA KAHLIAH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7823 PRESTON POINTE DR, FORT WAYNE, IN 46804-5705
(260) 205-4408
Mailing address
7823 PRESTON POINTE DR, FORT WAYNE, IN 46804-5705
(260) 205-4408
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
240174571
IN
3747P1801X
Personal Care Attendant
Primary
24017457
IN
374U00000X
Home Health Aide
240174571
IN
376J00000X
Homemaker
240174571
IN
376K00000X
Nurse's Aide
240174571
IN
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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