Individual
SHANEKA ELISE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5122 CHESTNUT LAKE DR, CHARLOTTE, NC 28227-4928
(336) 405-2900
Mailing address
5122 CHESTNUT LAKE DR, CHARLOTTE, NC 28227-4928
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
254818
NC
Other
Enumeration date
06/28/2023
Last updated
06/28/2023
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