Andraes N Johnson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN63232 Issued in GA

Practice address

4130 Michael PL
Hephzibah, GA 30815-5937

Phone

(706) 589-6667

NPI assigned

Mar 3, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1362268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1457692352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4902 LUTON DR",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308132237",
            "telephone_number": "706-589-6667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 MICHAEL PL",
            "city": "HEPHZIBAH",
            "state": "GA",
            "postal_code": "308155937",
            "telephone_number": "706-589-6667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4902 Luton Dr",
            "address_purpose": "LOCATION",
            "city": "Grovetown",
            "state": "GA",
            "postal_code": "308132237",
            "country_code": "US",
            "telephone_number": "706-589-6667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANDRAES",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-03",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "GA",
            "license": "062322",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN63232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA NURSING BOARD",
            "identifier": "LPN63232",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• JCJ Enterprises
• Eleonora Jenkins, D.M.D
• Tara Jenkins
• Miriam Jennings
• Jesus Is Lord Healthcare Services, Inc.
• Brian Johnson
• Fred Thomas Jones, R.PH
• Kerry Ann Kimala Jones
• Vannette Machelle Jones, RN
• Daeundra Shynece Jordan

• Licensed Practical Nurse in Hephzibah, GA
• Providers in Hephzibah, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.