Individual
MRS. MALINDA A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
5801 CROSSINGS BLVD, ANTIOCH, TN 37013-3130
(615) 941-8501
(615) 941-8102
Mailing address
5801 CROSSINGS BLVD, ANTIOCH, TN 37013-3130
(615) 941-8501
(615) 941-8102
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1043
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043
STATE LICENSE
TN
Enumeration date
03/08/2007
Last updated
03/07/2023
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