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Individual

SHONTAE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6621 N 107TH PLZ, OMAHA, NE 68122-3041
(402) 686-5627
Mailing address
6621 N 107TH PLZ # OMAHANE, OMAHA, NE 68122-3041
(402) 686-5627

Taxonomy

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

Other

Enumeration date
03/21/2025
Last updated
03/21/2025
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