Healthcare Provider Details

I. General information

NPI: 1588069736
Provider Name (Legal Business Name): KAREN E JOHNSON RN, MPH, ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2014
Last Update Date: 10/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13303 LAKE TIMBER CT
CYPRESS TX
77429-7689
US

IV. Provider business mailing address

13303 LAKE TIMBER CT
CYPRESS TX
77429-7689
US

V. Phone/Fax

Practice location:
  • Phone: 281-251-5769
  • Fax:
Mailing address:
  • Phone: 281-251-5769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License Number519939
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: