Johnson, Peggy Lavern

Johnson, Peggy Lavern is an sole proprietor health care provider with primary practice located at 4455 Confederate Point Rd Apartment 10-D, Jacksonville FL 32210-5757. She recently has only one registered license in Nursing Service Related Providers / Personal Care Attendant, which is considered as her primary health care specialty. Johnson, Peggy Lavern can be contacted via phone (904) 400-8723.

Contact Information

Primary practice address
4455 Confederate Point Rd Apartment 10-D Jacksonville FL 32210-5757
Phone: (904) 400-8723
Fax: (904) 374-5251
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Personal Care Attendant 3747P1801X

Profile Details

NPI number 1669806345
LBN Legal business name Johnson, Peggy Lavern
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 29th, 2013
Last updated Aug 29th, 2013 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669806345 NPPES
Florida MEDICAID 691051396

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