Tyeanna Goodall Johnson
Individual provider Active NPI Doula · Brackettville, TX
NPI 1912770280 · NPPES record last updated Oct 30, 2023
Key facts
- NPI
- 1912770280
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Doula 374J00000X
- Practice address
- 72 Sunset Lane
Brackettville, TX 78832-0270 - Phone
- (509) 251-9952
- NPI assigned
- Oct 30, 2023
- 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 |
|---|---|---|---|---|
| Doula | 374J00000X | Yes |
Addresses
Primary practice location
72 Sunset Lane
Brackettville, TX 78832-0270
Mailing address
PO Box 270
Brackettville, TX 78832-0270
Phone (509) 251-9952
Other providers in Brackettville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2023. 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.