Individual
KIMBERLY R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9263 MEDICAL PLAZA DR, STE E, CHARLESTON, SC 29406-7112
(843) 572-1228
(877) 561-7564
Mailing address
41 25TH AVE, ISLE OF PALMS, SC 29451-2369
(843) 886-6960
(877) 561-7564
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
58
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN0561
—
SC
Enumeration date
02/05/2007
Last updated
11/14/2013
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