Dasjarae Brior Johnson
Individual provider Active NPI Driver · Owensboro, KY
NPI 1700523834 · NPPES record last updated May 19, 2022
Key facts
- NPI
- 1700523834
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- J11173829 (KY)
- Practice address
- 126 W 20TH St Ste a
Owensboro, KY 42303-3704 - Phone
- (270) 370-7815
- NPI assigned
- May 19, 2022
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| J11173829 | KY | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | J11173829 | KY | Yes |
Addresses
Primary practice location
126 W 20TH St Ste a
Owensboro, KY 42303-3704
Mailing address
PO Box 1252
Owensboro, KY 42302-1252
Phone (270) 370-7815
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | mylestransportation07@gmail.com | Direct |
Other providers in Owensboro, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2022. 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.