Provider Demographics
NPI:1043843766
Name:JOHNSON, BRIANNA CRESHA
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:CRESHA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 MINNESOTA AVE SE APT 203
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-7392
Mailing Address - Country:US
Mailing Address - Phone:202-848-9453
Mailing Address - Fax:
Practice Address - Street 1:2612 NAYLOR RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7260
Practice Address - Country:US
Practice Address - Phone:301-672-9031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-20
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant