Individual
SAMUEL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPT, PN1, BCS, CES
Contact information
Practice address
5720 STONE BROOK DR, BRENTWOOD, TN 37027-4640
(615) 972-3862
Mailing address
5720 STONE BROOK DR, BRENTWOOD, TN 37027-4640
(615) 972-3862
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
171400000X
Health & Wellness Coach
—
MO
174H00000X
Health Educator
—
—
Other
Enumeration date
09/02/2022
Last updated
09/02/2022
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