National Provider Identifier

Shawntalae Johnson, LPN

Shawntalae Johnson, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in W Henrietta, NY and a listed phone number of (585) 719-6875.

NPI 1104199272W Henrietta, NYLicensed Practical Nurse

Profile Overview

NPI
1104199272
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
February 20, 2012
Last Updated
February 20, 2012

Practice Location

  • 26 Blazing Star Cir
  • W Henrietta, NY 14586-9335

Phone: (585) 719-6875

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1104199272
Entity Type
Individual
Last Name
Johnson
First Name
Shawntalae
Credential
LPN
Mailing Street Address
26 Blazing Star Cir
Mailing City
W Henrietta
Mailing State
NY
Mailing ZIP Code
14586-9335
Mailing Country
US
Mailing Phone
(585) 719-6875
Practice Street Address
26 Blazing Star Cir
Practice City
W Henrietta
Practice State
NY
Practice ZIP Code
14586-9335
Practice Country
US
Practice Phone
(585) 719-6875
Enumeration Date
February 20, 2012
Last Updated
February 20, 2012
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)