JOHNETTA MATHIS REGISTERED NURSE
NPI 1619564531
Licensed Practical Nurse in Eastpointe, MI

Q: What is Johnetta Mathis's NPI number?

The NPI number for Johnetta Mathis is 1619564531. It was assigned to this individual provider in the NPPES registry on December 26, 2020.

Q: What is Johnetta Mathis's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

Q: When was this NPI record last updated?

The NPPES record for Johnetta Mathis was last updated on July 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 26, 2020

16743 LINCOLN AVE, EASTPOINTE, MI 48021(313) 477-7366 Get Directions Write a Review

NPPES record last updated: July 15, 2025. Verified against the NPPES registry weekly; last sync: September 06, 2026.

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About Johnetta Mathis Registered Nurse NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHNETTA MATHIS REGISTERED NURSE (NPI 1619564531) is an individual licensed practical nurse in Eastpointe, Michigan, licensed in Michigan (4703121100) and active in the NPI registry since December 2020.

NPPES Registry Identity

NPI1619564531

Entity TypeIndividualFemale

Primary Taxonomy164W00000X

Provider Legal NameJOHNETTA MATHISCredential: REGISTERED NURSE

Location Address16743 LINCOLN AVEEastpointe, MI 48021-3029

Mailing Address16743 Lincoln AveEastpointe, MI 48021-3029 · (313) 477-7366

Phone(313) 477-7366

Sole ProprietorNo

Enumeration DateDecember 26, 2020

Last NPPES UpdateJuly 15, 2025

NPPES CertifiedJuly 15, 2025

✔ NPI 1619564531 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers

Taxonomy Code164W00000X

License✔ Licensed in MI · 4703121100

Definition

A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Also ListedRegistered NurseTaxonomy 163W00000X · License 4704427375 (MI)

16743 LINCOLN AVE, Eastpointe, MI 48021

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COMFORT HANDS HOME SERVICES LLC

In Home Supportive Care

16743 LINCOLN AVE
EASTPOINTE, MI 48021

Macomb County (313) 477-7366

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Johnetta Mathis's NPI number?

The NPI number for Johnetta Mathis is 1619564531. It was assigned to this individual provider in the NPPES registry on December 26, 2020.

Where is Johnetta Mathis located?

Johnetta Mathis practices at 16743 Lincoln Ave, Eastpointe, MI 48021. The listed phone number is (313) 477-7366.

What is Johnetta Mathis's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Johnetta Mathis was last updated on July 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.