Individual
CONSTANCE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4824 GILHEM CT, COLUMBUS, OH 43228-5764
(678) 663-8409
Mailing address
4824 GILHEM CT, COLUMBUS, OH 43228-5764
(678) 663-8409
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
0209433
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0209433
—
OH
05
—
QMP000005250183
—
OH
Enumeration date
08/21/2017
Last updated
08/21/2017
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