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Individual

CRESHINE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
215 LARDNER ST, PHILADELPHIA, PA 19111-5907
(267) 235-6792
Mailing address
215 LARDNER ST, PHILADELPHIA, PA 19111-5907
(267) 235-6792

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
374U00000X
Home Health Aide
376K00000X
Nurse's Aide
Primary

Other

Enumeration date
11/29/2019
Last updated
11/29/2019
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