Provider Demographics
NPI:1689236614
Name:JOHNSON, ALAJSHA JEUNEE' (LPN)
Entity Type:Individual
Prefix:
First Name:ALAJSHA
Middle Name:JEUNEE'
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 1:5946 WALNUT CIR APT L
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-6623
Mailing Address - Country:US
Mailing Address - Phone:419-708-7368
Mailing Address - Fax:
Practice Address - Street 1:5946 WALNUT CIR APT L
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-6623
Practice Address - Country:US
Practice Address - Phone:419-708-7368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-29
Last Update Date:2019-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.170852164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse