Individual
KAITLIN BROOKE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2301 S HAMPTON RD STE 900, DALLAS, TX 75224-1677
(214) 330-9201
Mailing address
2301 S HAMPTON RD STE 900, DALLAS, TX 75224-1677
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA12335
TX
Other
Enumeration date
11/16/2018
Last updated
11/16/2018
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