Individual
DIONNA LATRICE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4417 LUCILLE AVE, SOUTH EUCLID, OH 44121-3538
(216) 334-7133
Mailing address
4417 LUCILLE AVE, SOUTH EUCLID, OH 44121-3538
(216) 334-7133
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
156162
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07072018
MEDICARE
OH
05
—
11151981
—
OH
Enumeration date
10/31/2018
Last updated
05/11/2026
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