Individual
MICHELLE EILEEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., R.D., LDN
Contact information
Practice address
2151 CENTURY LN, JOHNSON CITY, TN 37604-4469
(423) 926-2500
(423) 926-5999
Mailing address
807 UNIVERSITY PKWY BOX 70403, JOHNSON CITY, TN 37614-1703
(423) 439-4071
(423) 439-4060
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2479
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LDN2479
STATE
TN
05
—
Q34398
—
TN
Enumeration date
12/02/2008
Last updated
01/18/2024
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