Individual
KIMBERLY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,NP
Contact information
Practice address
111 DOCTOR CIR, COLUMBIA, SC 29203-6502
(800) 491-0909
Mailing address
111 DOCTOR CIR, COLUMBIA, SC 29203-6502
(800) 491-0909
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
24052
SC
363LA2100X
Acute Care Nurse Practitioner
Primary
24253
SC
363LA2200X
Adult Health Nurse Practitioner
307462
NY
Other
Enumeration date
08/14/2015
Last updated
03/27/2026
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