Provider Demographics
NPI:1790077063
Name:JOHNSON, BRITTNEY LYNN (RN)
Entity Type:Individual
Prefix:MS
First Name:BRITTNEY
Middle Name:LYNN
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 1:4287 E LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44054-1249
Mailing Address - Country:US
Mailing Address - Phone:440-752-2602
Mailing Address - Fax:
Practice Address - Street 1:4287 E LAKE RD
Practice Address - Street 2:
Practice Address - City:SHEFFIELD LAKE
Practice Address - State:OH
Practice Address - Zip Code:44054-1249
Practice Address - Country:US
Practice Address - Phone:440-752-2602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN365498163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2460171Medicare PIN