MEDICARE: KATIE JOHNSON

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	174400000X	Specialist

General Provider Information

NPI Number	:	1538091020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE JOHNSON

Provider Business Mailing Address
First Line	:	29 SCHOOL ST
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-4033
Country	:	US
Telephone Number	:	603-226-7505
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 PLEASANT ST
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-3852
Country	:	US
Telephone Number	:	603-226-7505
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ KATIE JOHNSON ” Practice Location

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