Provider Demographics
NPI:1114514072
Name:JOHNSON, DARCY JEAN (CNA)
Entity Type:Individual
Prefix:MISS
First Name:DARCY
Middle Name:JEAN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7261 MEADOWBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-8942
Mailing Address - Country:US
Mailing Address - Phone:865-242-3849
Mailing Address - Fax:865-498-0350
Practice Address - Street 1:7261 MEADOWBROOK CIR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-8942
Practice Address - Country:US
Practice Address - Phone:865-242-3849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN140671376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide