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Individual
MS. KRISTINA A JOHNSON
Active
Individual
MS. KRISTINA A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001768
IA
363AM0700X
Medical Physician Assistant
001768
IA
363AS0400X
Surgical Physician Assistant
001768
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35349
WELLMARK
IA
05
—
8123083
—
IA
01
—
P00374217
RR MEDICARE
IA
Enumeration date
11/10/2006
Last updated
08/01/2023
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