Provider Demographics
NPI:1851113872
Name:JOHNSON, JOLEIGH BETH (RN)
Entity type:Individual
Prefix:
First Name:JOLEIGH
Middle Name:BETH
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 1:2042 WHITE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:TN
Mailing Address - Zip Code:37366-3042
Mailing Address - Country:US
Mailing Address - Phone:931-952-1483
Mailing Address - Fax:
Practice Address - Street 1:2042 WHITE RIDGE RD
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:TN
Practice Address - Zip Code:37366-3042
Practice Address - Country:US
Practice Address - Phone:931-952-1483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN230106163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health