Individual
KRISTINE L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
69200-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023498441
—
WI
Enumeration date
06/01/2015
Last updated
04/22/2024
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