Provider Demographics
NPI:1063714590
Name:JOHNSON, RASHEDA YEVETTE (RN)
Entity type:Individual
Prefix:
First Name:RASHEDA
Middle Name:YEVETTE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19831 LOCHERIE AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44119-1423
Mailing Address - Country:US
Mailing Address - Phone:216-692-1582
Mailing Address - Fax:
Practice Address - Street 1:19831 LOCHERIE AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44119-1423
Practice Address - Country:US
Practice Address - Phone:216-692-1582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-05
Last Update Date:2010-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH360061163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse