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Contact Information

JACLYN A JOHNSON
370 CEDAR VALLEY RD
POUGHKEEPSIE, NY12603
 Phone: 845-625-4567
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Licensed Practical Nurse

164W00000X
Indicates primary specialty

NPI Profile & details for JACLYN A JOHNSON · (Female)

NPI # 1013555812
Status Active
Credentials
Entity Individual
Enumeration date 12/12/2019
Last updated 12/12/2019 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 322960
  • NY Medicaid 322960
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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