Individual
KATRINA A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
600 N ROBBINS ROAD, SUITE 100, BOISE, ID 83702-4566
(208) 383-0201
(208) 489-4300
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 383-0201
(208) 383-1130
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
08/13/2009
Last updated
04/05/2011
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