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General NPI Number Information
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NPI Number | 1154354223
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Entity Type | Individual
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Provider Name | BROOK A. JOHNSON PA
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Gender | Female
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 910 BLACKFORD ST
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City | CHATTANOOGA
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State | TN
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Zip | 37403-1405
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Country | US
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Telephone | 423-778-6011
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Fax | 865-539-8008
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Provider Business Mailing Address
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Address Line | PO BOX 634811
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City | CINCINNATI
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State | OH
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Zip | 45263-4811
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA0000001176
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 66852
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 13224
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License Number State | GA
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