Individual
MRS. ALISA KATHLEEN JOHNSON
Active
Individual
MRS. ALISA KATHLEEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
55894-20
WI
2085R0202X
Diagnostic Radiology Physician
Primary
DR.0057838
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000037070
MEDICARE PTAN
WI
Enumeration date
01/31/2007
Last updated
02/04/2021
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