Individual
KIMBERLY GREENWOOD JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUDIOLOGIST
Contact information
Practice address
653 W 8TH ST, UFJAX - DEPT. OF SURGERY/OTOLARYNGOLOGY, JACKSONVILLE, FL 32209-6511
(904) 244-7463
(904) 244-7730
Mailing address
PO BOX 44008, UFJP - PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3199
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY1591
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0024601-00
—
FL
05
—
694050310A
—
GA
Enumeration date
05/27/2010
Last updated
08/30/2011
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