Individual
KIMBERLY A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
100 ENTERPRISE DR, YORKTOWN, VA 23692-3190
(757) 736-3725
(757) 431-7782
Mailing address
100 ENTERPRISE DR, YORKTOWN, VA 23692-3190
(757) 736-3725
(757) 431-7782
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024177320
VA
363LF0000X
Family Nurse Practitioner
138414
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
138414
RN FNPC LICENSE NUMBER
MO
05
—
1730150889
—
MO
01
—
P01230388
RR MEDICARE
MO
Enumeration date
01/27/2006
Last updated
01/16/2023
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