Provider Demographics
NPI:1477378388
Name:JOHNSON, BRITTANY EILEEN
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:EILEEN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LEGION
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:16 MALVERN ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14613-2536
Mailing Address - Country:US
Mailing Address - Phone:585-498-9195
Mailing Address - Fax:
Practice Address - Street 1:16 MALVERN ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14613-2536
Practice Address - Country:US
Practice Address - Phone:585-498-9195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No376J00000XNursing Service Related ProvidersHomemaker