Individual
NATISHA TAMEL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
448 RIGLAW CIR, LEXINGTON, SC 29073-7825
(803) 238-1900
Mailing address
448 RIGLAW CIR, LEXINGTON, SC 29073-7825
(803) 238-1900
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P40470
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4101977
BIRTHDAY
SC
Enumeration date
01/23/2018
Last updated
01/23/2018
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