Provider Demographics
NPI:1225460959
Name:JOHNSON, LAMEEKIAA (RN)
Entity Type:Individual
Prefix:
First Name:LAMEEKIAA
Middle Name:
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 1:508 BENONI AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-2631
Mailing Address - Country:US
Mailing Address - Phone:304-657-0244
Mailing Address - Fax:
Practice Address - Street 1:508 BENONI AVE
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-2631
Practice Address - Country:US
Practice Address - Phone:304-657-0244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV118066363L00000X
WV76813163WG0000X, 163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy