Individual
AUDREA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA/HHA
Contact information
Practice address
701 GRANITE ROAD, BRANDON, FL 33510
(813) 539-1794
Mailing address
701 GRANITE ROAD, BRANDON, FL 33510
(813) 539-1794
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
0000000000
FL
374U00000X
Home Health Aide
—
FL
374U00000X
Home Health Aide
—
—
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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