Roberta R Johnston, LPN

Individual provider Active NPI Licensed Practical Nurse · Dorset, OH

NPI 1639366131 · NPPES record last updated Sep 27, 2007

Key facts

NPI
1639366131
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN113643 (OH)
Practice address
3197 Footville Richmond Rd
Dorset, OH 44032-9605
Phone
(440) 858-2333
NPI assigned
Sep 27, 2007
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

State licenses

LicenseStateTypeSpecialty
PN113643OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN113643 OH Yes

Addresses

Primary practice location

3197 Footville Richmond Rd
Dorset, OH 44032-9605

Mailing address

3197 Footville Richmond Rd
Dorset, OH 44032-9605
Phone (440) 858-2333

Other providers in Dorset, OH

All providers in Dorset, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.