Provider Demographics
NPI:1689498057
Name:JOHNSON, DAYONNA
Entity type:Individual
Prefix:
First Name:DAYONNA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2722 S SAINT PETERS PKWY STE 2
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63303-6376
Mailing Address - Country:US
Mailing Address - Phone:314-643-1662
Mailing Address - Fax:
Practice Address - Street 1:2722 S SAINT PETERS PKWY STE 2
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63303-6376
Practice Address - Country:US
Practice Address - Phone:314-643-1662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide