Provider Demographics
NPI:1003506031
Name:JOHNSON, BRITTANY LEANNE (COMMUNITY HEALTH AID)
Entity Type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:LEANNE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:COMMUNITY HEALTH AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 112
Mailing Address - Street 2:
Mailing Address - City:YAKUTAT
Mailing Address - State:AK
Mailing Address - Zip Code:99689-0112
Mailing Address - Country:US
Mailing Address - Phone:907-784-3275
Mailing Address - Fax:907-784-3263
Practice Address - Street 1:115 AIRPORT ROAD
Practice Address - Street 2:
Practice Address - City:YAKUTAT
Practice Address - State:AK
Practice Address - Zip Code:99689
Practice Address - Country:US
Practice Address - Phone:907-784-3275
Practice Address - Fax:907-784-3263
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK23-1692-I172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker