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Individual

KELLY COOKE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AUD

Contact information

Practice address
110 CORNING RD, CARY, NC 27518-9229
(919) 431-7400
Mailing address
4613 FISK CT, RALEIGH, NC 27604-8401

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
14997
NC
231H00000X
Audiologist
NC
2355A2700X
Audiology Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1568039378
NC
Enumeration date
06/09/2021
Last updated
04/15/2026
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