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General NPI Number Information
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NPI Number | 1093682486
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Entity Type | Individual
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Provider Name | MS. MONIKA NICOLE JOHNSON
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Gender | Female
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Dates
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Enumeration Date | 10/20/2025
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 4881 15TH STREET RD
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City | HUEYTOWN
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State | AL
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Zip | 35023-5767
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Country | US
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Telephone | 855-741-2229
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Fax |
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Provider Business Mailing Address
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Address Line | 5829 HATCHERS RUN
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City | PINSON
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State | AL
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Zip | 35126-5524
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 3021
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License Number State | AL
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