Provider Demographics
NPI:1114630597
Name:JOHNSON, HOPE RENEE (CAREGIVER)
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:RENEE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CAREGIVER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1822 APPLETON LN APT 1
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216-6002
Mailing Address - Country:US
Mailing Address - Phone:502-436-5082
Mailing Address - Fax:
Practice Address - Street 1:1822 APPLETON LN APT 1
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-6002
Practice Address - Country:US
Practice Address - Phone:502-436-5082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide