Johnson, Katrina M
Johnson, Katrina M is an sole proprietor health care provider with primary practice located at 10225 Magnolia Ridge Dr , Jacksonville FL 32210-4991. She recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Developmental Disabilities, Agencies / In Home Supportive Care. Agencies / In Home Supportive Care is her primary health care specialty. Johnson, Katrina M can be contacted via phone (904) 923-3505.Contact Information
Primary practice address
10225 Magnolia Ridge Dr
Jacksonville FL 32210-4991
Phone: (904) 923-3505
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Developmental Disabilities | 261QD1600X | ||
| Agencies / In Home Supportive Care | 253Z00000X |
Profile Details
| NPI number | 1063970358 |
|---|---|
| LBN Legal business name | Johnson, Katrina M |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 6th, 2019 |
| Last updated | Mar 6th, 2019 - about 5 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 | 1063970358 | NPPES |
| Florida | MEDICAID | 100716400 |
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