Individual
MRS. ADINA RUTH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, CSOWM, LDN
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 956-0621
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 956-0079
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1804
TN
Other
Enumeration date
10/27/2006
Last updated
06/26/2023
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