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Individual
ALICIA C JOHNSON
Active
Individual
ALICIA C JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSA
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2389
NAT'L SURGICAL ASST ASSOC
KY
01
—
86585
NAT'L CERT SURG TECH
KY
01
—
SA187
KENTUCKY MEDICAL LICENSURE
KY
Enumeration date
01/22/2008
Last updated
12/04/2020
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