Provider Demographics
NPI:1154651891
Name:JOHNSON, TAUNYA LLVERTRICE (RN)
Entity Type:Individual
Prefix:MRS
First Name:TAUNYA
Middle Name:LLVERTRICE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:TAUNYA
Other - Middle Name:LLVERTRICE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:20 ESTATE CT
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29115-8197
Mailing Address - Country:US
Mailing Address - Phone:803-878-2389
Mailing Address - Fax:
Practice Address - Street 1:20 ESTATE CT
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29115-8197
Practice Address - Country:US
Practice Address - Phone:803-878-2389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-31
Last Update Date:2021-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY574725-1163WH0200X
SC62887163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health