Individual
KIMBERLY CRUMP JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2809 PINE ST, UNADILLA, GA 31091-7701
(478) 627-3213
(478) 627-3669
Mailing address
PO BOX 1297, HAWKINSVILLE, GA 31036-7297
(478) 624-3213
(478) 627-3669
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN093193
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003120293A
—
GA
Enumeration date
08/23/2010
Last updated
08/06/2015
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