Mini John

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

963904 Issued in TX

Practice address

2405 Hickey Dr
Garland, TX 75043-1757

Phone

(325) 271-1237

NPI assigned

Feb 20, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

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": "1740009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1902602998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 HICKEY DR",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750431757",
            "telephone_number": "325-271-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 HICKEY DR",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750431757",
            "telephone_number": "325-271-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "MINI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "TX",
            "license": "963904",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "TX",
            "license": "963904",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "963904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Eun Young Jo, NP
• Alexandra Eleanor Jodaitis-Rodriguez, LPC
• Rachel Frances Johannes, M.S.,CCC-SLP
• John Etchu Dynasty Homecare Services
• John V. Lam DDS, PLLC
• Renji John
• Sheeba John
• Stanley Chacko John, DMD
• Lizy Jimmy Johns, DNP, RN, FNP-BC
• Michelle L Johns

• Registered Nurse in Garland, TX
• Providers in Garland, TX by specialty
• Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.