Healthcare Provider Details

I. General information

NPI: 1164697272
Provider Name (Legal Business Name): CATHARINE JOHNSON RRT RCP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 30TH ST
DES MOINES IA
50310-5753
US

IV. Provider business mailing address

507 PARKWOOD CIR
HUXLEY IA
50124-9320
US

V. Phone/Fax

Practice location:
  • Phone: 515-699-5999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number02032
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: