Johnson, Ardena

Johnson, Ardena is an individual health care provider with primary practice located at 60 Lightwood Dr , Covington GA 30016. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Johnson, Ardena can be contacted via phone (678) 467-2778.

Contact Information

Primary practice address
60 Lightwood Dr Covington GA 30016
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1881862159
LBN Legal business name Johnson, Ardena
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2008
Last updated Jun 27th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881862159 NPPES
Georgia MEDICAID 102164303C

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