Individual
LYDIA LAJOYCE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
10610 HWY 59 N, WOODLAWN, TX 75694
(903) 407-9973
Mailing address
10610 HWY 59 N, P. O. BOX 20 (MAILING), WOODLAWN, TX 75694
(903) 407-9973
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
347578
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164X00000X
—
TX
Enumeration date
07/26/2019
Last updated
07/26/2019
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