Individual
KENNETH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
204 10TH AVE S, NAMPA, ID 83651-3832
(208) 466-2229
(208) 466-2667
Mailing address
204 10TH AVE S, NAMPA, ID 83651-3832
(208) 466-2229
(208) 466-2667
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
10/20/2025
Last updated
10/24/2025
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