Individual
PEGGY LAVERN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4455 CONFEDERATE POINT RD, APARTMENT 10-D, JACKSONVILLE, FL 32210-5757
(904) 400-8723
(904) 374-5251
Mailing address
4455 CONFEDERATE POINT RD, APARTMENT 10-D, JACKSONVILLE, FL 32210-5757
(904) 400-8723
(904) 374-5251
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
691051396
—
FL
Enumeration date
08/29/2013
Last updated
08/29/2013
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