Provider Demographics
NPI:1851080329
Name:JOHNSON, RAYMONDA SHEKENYA (RN)
Entity Type:Individual
Prefix:
First Name:RAYMONDA
Middle Name:SHEKENYA
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 1:2881 SANDHILL RIDGE CT APT 317
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7453
Mailing Address - Country:US
Mailing Address - Phone:863-605-5354
Mailing Address - Fax:
Practice Address - Street 1:7380 W SAND LAKE RD STE 500
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5257
Practice Address - Country:US
Practice Address - Phone:863-605-5354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9500478163WI0500X, 163WM0705X, 163WC0200X, 163WP0808X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health