Provider Demographics
NPI:1821887670
Name:JOHNSON, KIEARA
Entity type:Individual
Prefix:
First Name:KIEARA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7828 CROSSOVER BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4519
Mailing Address - Country:US
Mailing Address - Phone:614-404-8919
Mailing Address - Fax:614-404-8919
Practice Address - Street 1:7828 CROSSOVER BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4519
Practice Address - Country:US
Practice Address - Phone:614-404-8919
Practice Address - Fax:614-404-8919
Is Sole Proprietor?:No
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker