Individual
KIMBERLY SANDERS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9430 PARK WEST BLVD, # 130, KNOXVILLE, TN 37923-4200
(865) 690-4861
(865) 560-8252
Mailing address
PO BOX 32569, KNOXVILLE, TN 37930-2569
(865) 694-0062
(865) 694-7907
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA0000001820
TN
363AS0400X
Surgical Physician Assistant
Primary
TEMPORARY PERMIT
TN
Other
Enumeration date
02/04/2010
Last updated
02/01/2013
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