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Individual

ANGELA JANE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHLEB/VENI,HOMEHEALT

Contact information

Practice address
24 REVERE CIR APT 13, JACKSON, TN 38305-3468
(731) 513-0975
Mailing address
24 REVERE CIR APT 13, JACKSON, TN 38305-3468
(731) 513-0975

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
146D00000X
Personal Emergency Response Attendant
172A00000X
Driver
173000000X
Legal Medicine
174200000X
Meals Provider
202K00000X
Phlebology Physician
JMCGHISSUED
TN
225400000X
Rehabilitation Practitioner
251E00000X
Home Health Agency
Primary
251F00000X
Home Infusion Agency
253Z00000X
In Home Supportive Care Agency
343900000X
Non-emergency Medical Transport (VAN)
374K00000X
Religious Nonmedical Practitioner

Other

Enumeration date
08/10/2020
Last updated
08/10/2020
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