MEDICARE: MRS. KRISTIN LANDHAM JOHNSON PA-C

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
1	363A00000X	Physician Assistant		AL

General Provider Information

NPI Number	:	1588980460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTIN LANDHAM JOHNSON PA-C

Provider Business Mailing Address
First Line	:	2333 HUNTINGTON RIDGE RD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35226-3205
Country	:	US
Telephone Number	:	205-307-8076
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 W LAKESHORE DR STE 100
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-7271
Country	:	US
Telephone Number	:	205-930-2950
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2010
Last Update Date	:	01/13/2026

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