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NPI Code Detail

MEDICARE: CHRISTINE JOHNSON

MEDICARE:   CHRISTINE  JOHNSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist2538-026WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396959763
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE JOHNSON
Provider Business Mailing Address
First Line : 15070 WOODBRIDGE RD
Second Line :
City : BROOKFIELD
State : WI
Zip : 53005-3665
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2727 W MITCHELL ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-2259
Country : US
Telephone Number : 414-383-3699
Fax Number : 414-383-3866
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2007
Last Update Date : 07/09/2007

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Directions to “ CHRISTINE JOHNSON ” Practice Location

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