Inga Demetria Paulk- Johnson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN055280 Issued in GA

Practice address

115 Lee St
Statesboro, GA 30458-2102

Phone

(912) 764-5884

NPI assigned

Jun 5, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1639338684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 LEE STREET",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-764-5884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 LEE ST",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304582102",
            "telephone_number": "912-764-5884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULK- JOHNSON",
        "first_name": "INGA",
        "middle_name": "DEMETRIA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN055280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mital Patel, PHARM. D.
• Rima Umesh Patel
• Suketu J. Patel, DMD, MD
• Ashley Patrick, SLP
• Lauren Olivia Patterson-Siekirk, PSY.D.
• Clint D Paxson, O.D.
• Mikala Payne
• Jordan William Paynter
• Jessica Pearson
• Charlize Pendleton

• Licensed Practical Nurse in Statesboro, GA
• Providers in Statesboro, 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 Jun 5, 2008; 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.