Provider Demographics
NPI:1700684842
Name:JOHNSON, CHEMIKIA
Entity type:Individual
Prefix:
First Name:CHEMIKIA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:SC
Mailing Address - Zip Code:29847-0097
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:41 PINE HOUSE RD STE 4
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:SC
Practice Address - Zip Code:29847-2084
Practice Address - Country:US
Practice Address - Phone:803-403-2091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker