Individual
MS. DEANNA KAY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTA
Contact information
Practice address
904 SUMNER ST, LINCOLN, NE 68502-2154
(402) 434-2670
(402) 434-2672
Mailing address
2444 O ST, LINCOLN, NE 68510-1125
(402) 475-7666
(402) 476-9623
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470398819
—
NE
Enumeration date
08/16/2012
Last updated
08/16/2012
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