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Individual
MISTY L. JOHNSON
Active
Individual
MISTY L. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1469
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1012470
CIGNA
NM
01
—
850463138
FEDERAL ID
NM
01
—
NMOOKK62
BLUE CROSS AND BLUE SHIEL
NM
Enumeration date
11/14/2005
Last updated
02/04/2022
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