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Individual

TANISHA RANAY JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4223 SACKETT AVE, CLEVELAND, OH 44109-1286
(216) 849-5927
Mailing address
4223 SACKETT AVE, CLEVELAND, OH 44109-1286
(219) 849-5927

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
402225161119
OH

Other

Enumeration date
01/26/2024
Last updated
01/26/2024
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