MEDICARE: EMMA JOHNSON NUTRITIONIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1033898432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMMA JOHNSON NUTRITIONIST

Provider Business Mailing Address
First Line	:	9326 SCORPIO LN
Second Line	:
City	:	MINT HILL
State	:	NC
Zip	:	28227-3631
Country	:	US
Telephone Number	:	704-762-1771
Fax Number	:	855-595-2959

Provider Business Practice Location Address
First Line	:	9326 SCORPIO LN
Second Line	:
City	:	MINT HILL
State	:	NC
Zip	:	28227-3631
Country	:	US
Telephone Number	:	704-762-1771
Fax Number	:	855-595-2959

Authorized Official
Title or Position	:	OWNER/REGISTERED DIETITIAN
Name	:	EMMA ALAINA JOHNSON
Credential	:	MS. RDN. LDN
Telephone Number	:	919-452-3979

Provider Enumeration Date	:	07/13/2023
Last Update Date	:	03/11/2026

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