Individual ProviderLaneir JohnsonNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address375 Wampanoag Trl, Riverside, RI 02915-2232(401) 649-4050(401) 443-4992PECOS EnrollmentBased on the most recent information from CMS, provider Laneir 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 yesterday at 12:57 PM.Profile DetailsProvider ID1447980776Provider TypeIndividualFull NameJohnson, LaneirCredentialFNPGenderFemaleSole ProprietorNoEnumeration Date6/10/2022Last Updated8/23/2022Contact InformationPractice LocationPractice Address375 Wampanoag Trl, Riverside, RI 02915-2232Phone(401) 649-4050Fax(401) 649-4051Mailing LocationMailing Address110 Elm St, Providence, RI 02903-4626Phone(401) 443-4992Fax(401) 537-7241Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN03148Rhode Island