JOHNETTA MATHIS REGISTERED NURSE NPI 1619564531

NPI Information

  • NPI: 1619564531
  • Provider Name: JOHNETTA MATHIS, REGISTERED NURSE
  • Classification: Licensed Practical Nurse - 164W00000X
  • Entity Type: Individual
  • Address: 16743 LINCOLN AVE
    EASTPOINTE, MI
    ZIP 48021
  • Phone: (313) 477-7366

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NPI Details

Johnetta Mathis, REGISTERED NURSE is a licensed practical nurse in Eastpointe, MI. The provider is a licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. Johnetta Mathis, REGISTERED NURSE NPI is 1619564531. 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:

16743 LINCOLN AVE
EASTPOINTE, MI
ZIP 48021-029
Phone: (313) 477-7366

The enumeration date for this NPI number is 12/26/2020 and was last updated on 7/15/2025.

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
1163W00000XRegistered Nurse4704427375MICHIGANNo
2164W00000XLicensed Practical Nurse4703121100MICHIGANYes

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: 11/21/2025

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