Holli Johnson
Individual provider Active NPI Personal Care Attendant · Bourneville, OH
NPI 1750008983 · NPPES record last updated Oct 27, 2022
Key facts
- NPI
- 1750008983
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 11493 U.S. RT 50
Bourneville, OH 45617-4561 - Phone
- (740) 542-9481
- NPI assigned
- Oct 27, 2022
- 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 | |||
| Personal Care Attendant | 3747P1801X | Yes |
Addresses
Primary practice location
11493 U.S. RT 50
Bourneville, OH 45617-4561
Mailing address
804 Harris Station Rd Apt Suite
Bainbridge, OH 45612-9734
Phone (740) 542-9481
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12345 | Medicaid | OH |
Other providers in Bourneville, OH
All providers in Bourneville, OH · Personal Care Attendant in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 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.