Individual ProviderCarolyn JohnsonLicensed Vocational NurseNursing Service ProvidersPractice Address2310 Buck Dr, Tyler, TX 75701-2406(903) 216-7229(903) 534-4684PECOS EnrollmentBased on the most recent information from CMS, provider Carolyn Johnson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:46 AM.Profile DetailsProvider ID1093215543Provider TypeIndividualFull NameJohnson, CarolynGenderFemaleSole ProprietorNoEnumeration Date2/20/2018Last Updated2/20/2018Contact InformationPractice LocationPractice Address2310 Buck Dr, Tyler, TX 75701-2406Phone(903) 216-7229FaxUnlisted FaxMailing LocationMailing Address755 S Beckham Ave, Tyler, TX 75701-1903Phone(903) 534-4684FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode164X00000XPrimaryDescriptionLicensed Vocational NurseNursing Service ProvidersLicense074266Texas