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TASHADA JOHNSON
>> Adult Companion >> Nursing Service Related ProvidersRegistrant NPI Number: 1679159594
Individual Registrant: TASHADA JOHNSON
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
255 PRIMERA BLVD STE 160 LAKE MARY, FL 32746-2168 US
Tel: 407-585-0825 Fax: --
Tel: 407-585-0825 Fax: --
Contact information for business:
255 PRIMERA BLVD STE 160 LAKE MARY, FL 32746-2168 US
Tel: 407-585-0825 Fax: --
Tel: 407-585-0825 Fax: --
Registration Information:
NPI: 1679159594
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 372600000X | Nursing Service Related Providers Adult Companion | FL | 28573 |
| Y | 376J00000X | Nursing Service Related Providers Homemaker | FL | 28573 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
