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Individual

AVERY LEIGH JOHNSON I

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
11011 Q ST STE 101C, OMAHA, NE 68137-3700
(308) 641-0403
Mailing address
422 1/2 W 20TH ST, SCOTTSBLUFF, NE 69361-1908
(308) 641-0403

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
NE

Other

Enumeration date
11/21/2025
Last updated
11/21/2025
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