IndividualActive
Roberta Johnson
NPI 1366109845 · Phlebotomy Technician · Centreville, IL
Provider details
- NPI number
- 1366109845
- Entity type
- Individual
- Primary specialty
- Phlebotomy TechnicianTechnologists, Technicians & Other Technical Service Providers
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Technologists, Technicians & Other Technical Service Providers
Practice location
1624 Boismenue Ave
Centreville, IL 62207-2131
Phone: (618) 698-3308
Approximate (ZIP-level) locationGet directions
Mailing address
1624 Boismenue Ave
Centreville, IL 62207-2131
Registry dates
- Enumerated
- 2021-11-19
- Last updated
- 2021-11-19
- Certified
- 2021-11-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.