Individual
MERCEDES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2101 BELMONT AVE, PHILADELPHIA, PA 19131-1648
(215) 800-5881
Mailing address
3791 LANKENAU RD, PHILADELPHIA, PA 19131-2816
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN304782
PA
Other
Enumeration date
05/27/2020
Last updated
05/27/2020
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