Provider Demographics
NPI:1033361167
Name:JOHNSON, YEMI KIKE (RN)
Entity Type:Individual
Prefix:MRS
First Name:YEMI
Middle Name:KIKE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 SAWGRASS DR
Mailing Address - Street 2:
Mailing Address - City:WESTAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-4739
Mailing Address - Country:US
Mailing Address - Phone:732-277-5234
Mailing Address - Fax:
Practice Address - Street 1:11 SAWGRASS DR
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-4739
Practice Address - Country:US
Practice Address - Phone:732-277-5234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR11935200163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health