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Individual

ANTONESHA BANAE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5928 N POINTE BLVD, SAINT LOUIS, MO 63147-1016
(314) 339-0749
Mailing address
5928 N POINTE BLVD, SAINT LOUIS, MO 63147-1016
(314) 339-0749

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary

Other

Enumeration date
02/23/2022
Last updated
04/15/2022
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Product
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  • Eligibility checks
  • EDI platform