Individual
KENYATTA LAFAYE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CERT. NURSING ASSIST
Contact information
Practice address
1546 MARTIN LUTHER KING JR AVE, WAUCHULA, FL 33873-9369
(863) 473-1896
Mailing address
1546 MARTIN LUTHER KING JR AVE, WAUCHULA, FL 33873-9369
(863) 473-1896
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
06/12/2021
Last updated
06/12/2021
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