Individual
MRS. CONSTANCE E JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
269 E MAIN ST, MADISON, OH 44057-3227
(440) 415-3077
Mailing address
269 E MAIN ST, MADISON, OH 44057-3227
(440) 415-3077
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
234320 OH
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2186530
—
OH
01
—
234340 OH
RN OH
OH
Enumeration date
06/30/2008
Last updated
06/30/2008
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