Johnson, Jeanette Deloris
Johnson, Jeanette Deloris is an sole proprietor health care provider with primary practice located at 29 Royal Leaf Ln , Palm Coast FL 32164-6998. She recently has 2 registered licenses in different health care specialties including Nursing Service Related Providers / Personal Care Attendant, Other Service Providers / Contractor. Other Service Providers / Contractor is her primary health care specialty. Johnson, Jeanette Deloris can be contacted via phone (386) 313-1609.Contact Information
Primary practice address
29 Royal Leaf Ln
Palm Coast FL 32164-6998
Phone: (386) 313-1609
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Related Providers / Personal Care Attendant | 3747P1801X | ||
| Other Service Providers / Contractor | 171W00000X |
Profile Details
| NPI number | 1235396144 |
|---|---|
| LBN Legal business name | Johnson, Jeanette Deloris |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 19th, 2008 |
| Last updated | Feb 27th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235396144 | NPPES |
| Florida | MEDICAID | 230362100 |
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