Johnson, Tanisha

Johnson, Tanisha is an individual health care provider with primary practice located at 495 Congress Ave , New Haven CT 06519-1312. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Johnson, Tanisha can be contacted via phone (203) 781-4600.

Contact Information

Primary practice address
495 Congress Ave New Haven CT 06519-1312
Phone: (203) 781-4600
Fax: (203) 781-4624
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 33133 Connecticut

Profile Details

NPI number 1316360134
LBN Legal business name Johnson, Tanisha
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2014
Last updated Jan 30th, 2014 - about 10 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1316360134 NPPES
Connecticut MEDICAID 008022622
Connecticut MEDICAID 008001325
Connecticut MEDICAID 004082260

Popular Providers