Johnson Chester Doe Jr.
Home Health Aide in Brooklyn Park, MN. Individual provider (NPI-1).
NPI number1407426224
StatusActive
Last updated in NPPESJun 25, 2021
Details
- NPI
- 1407426224
- Entity type
- Individual (NPI-1)
- Name
- Johnson Chester Doe Jr.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 25, 2021
- Certification date
- Jun 25, 2021
- Last updated
- Jun 25, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 374U00000X | Home Health Aide | – | – | Yes |
Practice location
5523 102nd Ave NBrooklyn Park, MN 55443-2074
Phone 763-639-2890
Mailing address
5523 102nd Ave NBrooklyn Park, MN 55443-2074
Phone 763-639-2890
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