Jeanette Deloris Johnson

NPI #1235396144 in Palm Coast, Florida

Provider Information

NPI Number: 1235396144
Entity Type: Individual
Name: Jeanette Deloris Johnson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Contractor
Enumeration Date: May 19, 2008
Last Updated: Feb 27, 2019

Practice Location

Address: 29 ROYAL LEAF LN
City: Palm Coast
State: Florida
ZIP Code: 32164-6998
Phone: (386) 313-1609

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician - Personal Care Attendant — Personal Care Attendant	3747P1801X
Contractor	171W00000X	Primary

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