Individual
ILYASAH Q JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA,PBT
Contact information
Practice address
115 PHILADELPHIA AVE, STE B #224, EGG HARBOR CITY, NJ 08215-1200
(856) 202-6243
Mailing address
890 E WALNUT RD APT 38, VINELAND, NJ 08360-5040
(609) 405-5974
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
5460-23
NJ
376K00000X
Nurse's Aide
NA200036261
NJ
Other
Enumeration date
01/16/2025
Last updated
01/27/2025
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