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Individual

MS. SHAMIRA CLINTONIA JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNA

Contact information

Practice address
217 W 5TH ST, CHESTER, PA 19013
(610) 803-5484
(610) 874-5837
Mailing address
217 W 5TH ST, CHESTER, PA 19013-4311
(610) 803-5484
(610) 874-5837

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
10019808
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10019808
NURSES AIDE REGISTRY
PA
01
6754270
STATE ENTITY NUMBER
PA
Enumeration date
08/16/2018
Last updated
08/17/2018
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