Individual
KATHLEEN C JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNM
Contact information
Practice address
330 E HIBISCUS BLVD, MELBOURNE, FL 32901-3155
(321) 724-2229
(321) 728-6668
Mailing address
330 E HIBISCUS BLVD, MELBOURNE, FL 32901-3155
(321) 724-2229
(321) 728-6668
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
APRN1949352
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012338500
—
FL
01
—
U2366
MEDICARE HF
FL
Enumeration date
04/07/2007
Last updated
04/15/2025
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