Individual
EMMONIA DENISE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1735 ROCK RIDGE DR, HOUSTON, TX 77049-1464
(832) 792-1931
Mailing address
13307 BABBITT ST, HOUSTON, TX 77034-2173
(832) 792-1931
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
193755
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007107004
DRIVERS LICENSE
LA
01
—
193755
NURSING LICENSE
TX
Enumeration date
08/22/2018
Last updated
08/22/2018
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