Provider Demographics
NPI:1467656801
Name:JOHNSON, ALICE K (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:K
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 CARINA DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-8331
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:817-719-3043
Practice Address - Street 1:1205 CARINA DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-8331
Practice Address - Country:US
Practice Address - Phone:817-719-2728
Practice Address - Fax:817-719-3043
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX685058163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health