Individual
KIMBERLY MCBRIDE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
ONE HOSPITAL DRIVE, COLUMBIA, MO 65212-0001
(573) 882-4909
(573) 884-5184
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
2012030845
MO
Other
Enumeration date
08/20/2012
Last updated
05/29/2013
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