Crystal L Johnson
Individual provider Active NPI Home Health Aide · Dale, TX
NPI 1295316271 · NPPES record last updated Apr 20, 2021
Key facts
- NPI
- 1295316271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Aide 374U00000X
- Practice address
- 11738 FM 1854
Dale, TX 78616-2935 - Phone
- (512) 559-0023
- NPI assigned
- Apr 20, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | Yes |
Addresses
Primary practice location
11738 FM 1854
Dale, TX 78616-2935
Mailing address
11738 FM 1854
Dale, TX 78616-2935
Phone (512) 559-0023
Other providers in Dale, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.