Healthcare Provider Details

I. General information

NPI: 1669997847
Provider Name (Legal Business Name): ERIN K JOHNSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2017
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 FOREST PARK AVE STE 710
SAINT LOUIS MO
63108-1495
US

IV. Provider business mailing address

4901 FOREST PARK AVE STE 710
SAINT LOUIS MO
63108-1495
US

V. Phone/Fax

Practice location:
  • Phone: 206-834-4100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number70086114
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number2022022404
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: