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General NPI Number Information
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NPI Number | 1952538746
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Entity Type | Individual
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Provider Name | KATIE JOHNSON D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/18/2009
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Last Update Date | 11/01/2019
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Provider Practice Location Address
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Address Line | 32060 LONG NECK RD
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City | MILLSBORO
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State | DE
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Zip | 19966-6228
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Country | US
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Telephone | 214-820-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 32060 LONG NECK RD
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City | MILLSBORO
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State | DE
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Zip | 19966-6228
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C2-0012072
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | P3360
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | BP10033996
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | C2-0012072
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License Number State | DE
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