Individual
MS. KIMBERLY RENEE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EP
Contact information
Practice address
5645 DANVERS RD, PORTSMOUTH, VA 23703-3730
(804) 368-9767
Mailing address
5645 DANVERS RD, PORTSMOUTH, VA 23703-3730
(804) 368-9767
Taxonomy
Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
Primary
901698244
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
901698244
ACSM - AMERICAN COLLEGE OF SPORTS MEDICINE
VA
Enumeration date
07/30/2020
Last updated
07/30/2020
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