Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | ACADEMIC | TN |
Y | 222Z00000X | Podiatrist | ACADEMIC | TN |
NPI | 1013407709 |
---|---|
Provider Name | Dr. Heather Morgan Johnson |
First Address | Alva, FL 33920-4651 |
Second Address | Johnson City, TN 37604-5453 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2018 |
Last Update Date | 17/05/2018 |