IndividualActive
Lavon Johnson, IDMT
NPI 1962828806 · Independent Duty Medical Technicians · Nellis Afb, NV
Provider details
- NPI number
- 1962828806
- Entity type
- Individual
- Primary specialty
- Independent Duty Medical TechniciansOther Service Providers
- Credential
- IDMT
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Practice location
4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600
Phone: (702) 653-2273
Approximate (ZIP-level) locationGet directions
Mailing address
4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600
Registry dates
- Enumerated
- 2014-03-17
- Last updated
- 2022-05-03
- Certified
- 2022-05-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.