Emery Leroy Johnson Jr.

Individual provider Active NPI Licensed Practical Nurse · Transfer, PA

NPI 1003391731 · NPPES record last updated Sep 28, 2018

Key facts

NPI
1003391731
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN274204 (PA)
Practice address
3676 N Hermitage Rd
Transfer, PA 16154-1852
Phone
(330) 726-0700
NPI assigned
Sep 28, 2018
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PN274204PAMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN274204 PA Yes

Addresses

Primary practice location

3676 N Hermitage Rd
Transfer, PA 16154-1852

Mailing address

136 Fetsko Rd
West Middlesex, PA 16159-2306
Phone (724) 854-1435

Other providers in Transfer, PA

All providers in Transfer, PA · Licensed Practical Nurse in Pennsylvania

Sources for this page

Verify at the official NPI Registry.