Individual
KRISTIN MARIAH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
16 RAILWAY AVE., THREE FORKS, MT 59752
(406) 285-3251
(406) 285-6742
Mailing address
PO BOX 1078, THREE FORKS, MT 59752-1078
(406) 285-3251
(406) 285-6742
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
29346
MT
363LF0000X
Family Nurse Practitioner
NP720A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010152871
BLUE SHIELD
ID
05
—
807303400
—
ID
01
—
NPWR5
BLUE CROSS
ID
01
—
P00269935
RAILROAD RETIREMENT BOARD
—
Enumeration date
03/14/2006
Last updated
07/08/2007
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