Individual
SAMANTHIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4650 LIPSCOMB ST NE STE 14, PALM BAY, FL 32905-2997
(321) 527-4019
Mailing address
4650 LIPSCOMB ST NE STE 14, PALM BAY, FL 32905-2997
(321) 527-4019
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5228272
FL
Other
Enumeration date
08/09/2024
Last updated
08/09/2024
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