JEANETTE DELORIS JOHNSON NPI 1235396144

NPI Information

NPI: 1235396144
Provider Name: JEANETTE DELORIS JOHNSON
Classification: Contractor - 171W00000X
Entity Type: Individual
Address:
29 ROYAL LEAF LN
PALM COAST, FL
ZIP 32164
Phone: (386) 313-1609
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Jeanette Deloris Johnson is a contractor in Palm Coast, FL. The provider is a person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). Jeanette Deloris Johnson NPI is 1235396144. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

29 ROYAL LEAF LN
PALM COAST, FL
ZIP 32164-998
Phone: (386) 313-1609

The enumeration date for this NPI number is 5/19/2008 and was last updated on 2/27/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	171W00000X	Contractor				Yes
2	3747P1801X	Technician	Personal Care Attendant			No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	230362100	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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