Individual ProviderHeather JohnsonNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address4143 Fulton Dr NW, Canton, OH 44718-2819(330) 244-8888PECOS EnrollmentBased on the most recent information from CMS, provider Heather Johnson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1407396922Provider TypeIndividualFull NameJohnson, HeatherGenderFemaleSole ProprietorYesEnumeration Date3/2/2017Last Updated5/20/2021Contact InformationPractice LocationPractice Address4143 Fulton Dr NW, Canton, OH 44718-2819Phone(330) 244-8888FaxUnlisted FaxMailing LocationMailing Address4143 Fulton Dr NW, Canton, OH 44718-2819Phone(330) 244-8888Fax(330) 244-8850Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN.CNP.020497Ohio