Individual
TAEREKA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC, LAT
Contact information
Practice address
304 MELANIE CT, CLAYTON, NC 27520-5642
(919) 270-1674
Mailing address
304 MELANIE CT, CLAYTON, NC 27520-5642
(919) 270-1674
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
LAT-3172
NC
2255A2300X
Athletic Trainer
Primary
—
NC
Other
Enumeration date
06/01/2020
Last updated
02/06/2026
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