Individual
MS. AUDREY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2939 E 123RD ST, CLEVELAND, OH 44120-2665
(216) 848-7643
Mailing address
2939 E 123RD ST, CLEVELAND, OH 44120-2665
(216) 848-7643
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400382180704
OH
Other
Enumeration date
11/01/2013
Last updated
11/01/2013
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