Johnson, Judith L.

Johnson, Judith L. is an sole proprietor health care provider with primary practice located at 523 W Floating Feather Drive , Eagle ID 83616. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Johnson, Judith L. can be contacted via phone (208) 938-8588.

Contact Information

Primary practice address
523 W Floating Feather Drive Eagle ID 83616
Phone: (208) 938-8588
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X CNS18A, N10622 Idaho

Profile Details

NPI number 1366536948
LBN Legal business name Johnson, Judith L.
Credentials APRN, CNS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 3rd, 2006
Last updated May 16th, 2008 - about 18 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 1366536948 NPPES
Idaho MEDICAID 8058014
Idaho Other TBBV3
Idaho Other 000010025013
Idaho Other 890000586

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