Individual
KIMBERLY MARY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1230 W SPRING VALLEY RD, RICHARDSON, TX 75080-7709
(972) 643-3527
(972) 643-3500
Mailing address
1230 W SPRING VALLEY RD, RICHARDSON, TX 75080-7709
(972) 643-3527
Taxonomy
Speciality
Code
Description
License number
State
374T00000X
Religious Nonmedical Nursing Personnel
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194752873
THE LEAVES PROVIDER IDENTIFIER NUMBER
TX
Enumeration date
11/07/2013
Last updated
11/07/2013
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