Individual
BROOKE LAMETTA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1365 DEVONPORT DR, LEXINGTON, KY 40504-1552
(859) 309-2240
Mailing address
PO BOX 185, MILLERSBURG, KY 40348-0185
(859) 285-4768
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1177547
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
J03-973-942
—
KY
Enumeration date
08/26/2022
Last updated
08/26/2022
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