Provider Demographics
NPI:1275708190
Name:JOHNSON, MARIA BERNADETTE (RN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:BERNADETTE
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:PO BOX 25333
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45225
Mailing Address - Country:US
Mailing Address - Phone:513-235-7903
Mailing Address - Fax:
Practice Address - Street 1:708 DERRICK TURNBOW
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45214
Practice Address - Country:US
Practice Address - Phone:513-235-7902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN336489163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology