Individual
MRS. LINDA DIANE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2 FIFTH GREEN DR, TAOS, NM 87571-9513
(575) 737-9514
Mailing address
2 FIFTH GREEN DR, TAOS, NM 87571-9513
(575) 737-9514
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
523
NM
133VN1005X
Renal Nutrition Registered Dietitian
523
NM
Other
Enumeration date
11/11/2008
Last updated
11/11/2008
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