Provider Demographics
NPI:1306027818
Name:JOHNSON, ARLINDA LOUISE
Entity Type:Individual
Prefix:MISS
First Name:ARLINDA
Middle Name:LOUISE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 TOWNSEND BLVD APT 192
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-2748
Mailing Address - Country:US
Mailing Address - Phone:904-743-1492
Mailing Address - Fax:
Practice Address - Street 1:3400 TOWNSEND BLVD APT 192
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-2748
Practice Address - Country:US
Practice Address - Phone:904-743-1492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA56241376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide