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Individual
AMY BROOK JOHNSON
Active
Individual
AMY BROOK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2010-00834
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01019064
RR MEDICARE
NC
Enumeration date
06/09/2009
Last updated
08/12/2016
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