# MALINDA JOHNSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1801014329
- **Gender:** F
- **Credential:** PA-C, OTR

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | — | — | — |
| 363A00000X | Physician Assistant | 008486 | GA | Yes |
| 363A00000X | Physician Assistant | 0110006226 | VA | — |

## Other

- **Enumeration date:** 04/22/2007
- **Last updated:** 01/29/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | VVS858A | MEDICARE | VA |