Provider / Organization | NPI | Date Certified |
---|---|---|
TAQUAN JOHNSON | 1922607399 | 2020-10-18 |
Taquan Johnson is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1922607399. Registration indicates Taquan Johnson is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
Entity Type | Individual |
Provider Name | Taquan Johnson |
Practice Office Address | 2727 WOODSDALE DR MIDDLEBURG, FL US |
Practice Office Telephone | 9049108426 |
Mailing Address | 2727 WOODSDALE DR MIDDLEBURG, FL 320686891 US |
Business Telephone | 9049108426 |
Code | Practice | License No State |
---|---|---|
390200000X PRIMARY | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
193400000X SING | Group Code |