Individual
MRS. BROOK A. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
910 BLACKFORD ST, CHATTANOOGA, TN 37403-1405
(423) 778-6011
(865) 539-8008
Mailing address
PO BOX 634811, CINCINNATI, OH 45263-4811
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13224
GA
363A00000X
Physician Assistant
66852
CA
363A00000X
Physician Assistant
PA0000001176
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009938377
—
AL
01
—
4104205
BLUE CROSS
TN
05
—
593101463B
—
GA
Enumeration date
07/09/2006
Last updated
08/26/2025
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