Lore Johns, L.P.N.

Individual provider Active NPI Licensed Practical Nurse · Jasper, FL

NPI 1013312420 · NPPES record last updated Oct 28, 2014

Key facts

NPI
1013312420
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN 5206079 (FL)
Practice address
5683 US Highway 129 S
Jasper, FL 32052-6793
Phone
(386) 792-6540
NPI assigned
Oct 28, 2014
Sex
Female
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
PN 5206079FLMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN 5206079 FL Yes

Addresses

Primary practice location

5683 US Highway 129 S
Jasper, FL 32052-6793

Mailing address

209 Central Ave SE
Jasper, FL 32052-6153
Phone (386) 792-1414

Other providers in Jasper, FL

All providers in Jasper, FL · Licensed Practical Nurse in Florida

Sources for this page

Verify at the official NPI Registry.