Individual
MS. KIMBERLY L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
131 WELTON WAY, MOORESVILLE, NC 28117-9163
(704) 360-4564
(704) 360-4553
Mailing address
131 WELTON WAY, MOORESVILLE, NC 28117-9163
(704) 360-4564
(704) 360-4553
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
336144
NY
363LF0000X
Family Nurse Practitioner
Primary
5005051
NC
363LF0000X
Family Nurse Practitioner
F0709387
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518272707
NPI
NC
Enumeration date
08/11/2010
Last updated
08/01/2022
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