Sandra Deniece Johnson

Individual provider Active NPI Personal Care Attendant · Soldotna, AK

NPI 1962019786 · NPPES record last updated Sep 25, 2020

Key facts

NPI
1962019786
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
License
1584304 (AK)
Practice address
44661 Sterling Hwy Ste a
Soldotna, AK 99669-7900
Phone
(907) 929-5826
Fax
(907) 420-0530
NPI assigned
Sep 25, 2020
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

LicenseStateTypeSpecialty
1584304AKMDPersonal Care Attendant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X 1584304 AK Yes

Addresses

Primary practice location

44661 Sterling Hwy Ste a
Soldotna, AK 99669-7900

Mailing address

44661 Sterling Hwy Ste a
Soldotna, AK 99669-7900
Phone (907) 929-5826

Other identifiers

IdentifierTypeStateIssuer
1584304MedicaidAK

Electronic endpoints

TypeEndpointUseAffiliation
Other URL Heartsandhandsofcare.com Direct

Other providers in Soldotna, AK

All providers in Soldotna, AK · Personal Care Attendant in Alaska

Sources for this page

Verify at the official NPI Registry.