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NPI Code Detail

MEDICARE: KRISTI JOHNSON M.S., CCC-SLP

MEDICARE: KRISTI JOHNSON M.S., CCC-SLP
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
1235Z00000XSpeech-Language Pathologist2202005885VA

General Provider Information

NPI Number : 1740017458
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTI JOHNSON M.S., CCC-SLP
Provider Business Mailing Address
First Line : 4608 BURKETT CT
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23321-1279
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 640 NORTH ST
Second Line :
City : PORTSMOUTH
State : VA
Zip : 23704-2415
Country : US
Telephone Number : 757-967-9926
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2024
Last Update Date : 09/17/2024

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Directions to “ KRISTI JOHNSON M.S., CCC-SLP” Practice Location

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