Individual
KIMBERLY M JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
49 CLEVELAND ST, SUITE 240, CROSSVILLE, TN 38555-2855
(931) 456-5814
(931) 484-8216
Mailing address
49 CLEVELAND ST, SUITE 240, CROSSVILLE, TN 38555-2855
(931) 456-5814
(931) 484-8216
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD0000023982
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3005675
BLUE CROSS BLUE SHIELD
TN
05
—
3075326
—
TN
Enumeration date
07/13/2005
Last updated
07/11/2008
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