Individual
MS. NEDRA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5409 N JIM MILLER RD STE 211, DALLAS, TX 75227-1523
(214) 280-0379
(214) 817-2571
Mailing address
PO BOX 270376, DALLAS, TX 75227-0376
(214) 280-0379
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172A00000X
Driver
—
—
2472R0900X
Renal Dialysis Technician
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251T00000X
PACE Provider Organization
—
—
251V00000X
Voluntary or Charitable Agency
—
—
253J00000X
Foster Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
332U00000X
Home Delivered Meals
—
—
342000000X
Transportation Network Company
—
—
347C00000X
Private Vehicle
—
—
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
09/28/2017
Last updated
01/13/2023
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