Provider Demographics
NPI:1154673044
Name:JOHNSON, BELINDA MONIQUE (LPN)
Entity type:Individual
Prefix:
First Name:BELINDA
Middle Name:MONIQUE
Last Name:JOHNSON
Suffix:
Gender:
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 LILA ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70820-6418
Mailing Address - Country:US
Mailing Address - Phone:347-371-0517
Mailing Address - Fax:
Practice Address - Street 1:1515 LILA ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70820-6418
Practice Address - Country:US
Practice Address - Phone:347-371-0517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA30004065164W00000X
NY280665164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty