Provider Demographics
NPI:1285524330
Name:JOHNSON, LASHELE
Entity type:Individual
Prefix:
First Name:LASHELE
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:PO BOX 10181
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76547-0181
Mailing Address - Country:US
Mailing Address - Phone:254-499-6269
Mailing Address - Fax:254-213-0054
Practice Address - Street 1:9004 ASHLYN DR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-5954
Practice Address - Country:US
Practice Address - Phone:254-499-6269
Practice Address - Fax:254-213-0054
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No253Z00000XAgenciesIn Home Supportive Care