Individual
FAWN JANEEN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13117 CRENNELL AVE, CLEVELAND, OH 44105-4701
(216) 318-0126
Mailing address
397 E 222ND ST, APT B1, EUCLID, OH 44123-1747
(216) 318-0126
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN091152
OH
Other
Enumeration date
08/27/2008
Last updated
08/27/2008
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