Individual
PHYLLIS A JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
35 VARDEN DR STE A, AIKEN, SC 29803-5275
(803) 679-5005
Mailing address
35 VARDEN DR STE A, AIKEN, SC 29803-5275
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN016026
GA
Other
Enumeration date
11/07/2025
Last updated
11/07/2025
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