Provider Demographics
NPI:1598171050
Name:JOHNSON, LINDSAY MARIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:MARIE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-1787
Mailing Address - Country:US
Mailing Address - Phone:330-934-0934
Mailing Address - Fax:
Practice Address - Street 1:222 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-1787
Practice Address - Country:US
Practice Address - Phone:330-934-0934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-05
Last Update Date:2014-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.143704-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse