Individual
KRISTEN C JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
BEAUFORT MEMORIAL LOWCOUNTRY MEDICAL GROUP, 300 MIDTOWN DRIVE, BEAUFORT, SC 29906-5200
(843) 770-0404
(844) 296-2309
Mailing address
955 RIBAUT RD, BMAC CREDENTIALING, BEAUFORT, SC 29902-5441
(843) 522-5674
(843) 522-5678
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1310
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0673PA
—
SC
Enumeration date
06/24/2008
Last updated
07/24/2019
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