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General NPI Number Information
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NPI Number | 1730150889
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Entity Type | Individual
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Provider Name | KIMBERLY A JOHNSON APRN
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Gender | Female
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 01/16/2023
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Provider Practice Location Address
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Address Line | 100 ENTERPRISE DR
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City | YORKTOWN
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State | VA
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Zip | 23692-3190
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Country | US
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Telephone | 757-736-3725
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Fax | 757-431-7782
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Provider Business Mailing Address
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Address Line | 100 ENTERPRISE DR
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City | YORKTOWN
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State | VA
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Zip | 23692-3190
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Country | US
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Telephone | 757-736-3725
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Fax | 757-431-7782
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 138414
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024177320
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License Number State | VA
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