Individual
JACQUELINE M JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6140 S BROADWAY, LORAIN, OH 44053-3821
(440) 233-7232
(440) 233-9070
Mailing address
6140 S BROADWAY, LORAIN, OH 44053-3821
(440) 233-7232
(440) 233-9070
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
189335
OH
164W00000X
Licensed Practical Nurse
Primary
LPN.189335
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0163668
—
OH
Enumeration date
07/23/2025
Last updated
02/05/2026
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