Individual
KAREN RUTH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LMNT
Contact information
Practice address
4021 AVENUE B, SCOTTSBLUFF, NE 69361-4602
(308) 630-2051
(308) 630-1815
Mailing address
4021 AVENUE B, SCOTTSBLUFF, NE 69361-4602
(308) 630-2051
(308) 630-1815
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
610
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
610
STATE LICENSURE
NE
01
—
864129
CDR NUMBER
NE
Enumeration date
03/27/2007
Last updated
07/08/2007
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