Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 01059804A | IN |
N | 207VX0000X | Obstetrician | 63731-20 | WI |
NPI | 1043247190 |
---|---|
Provider Name | Kay F Johnson |
First Address | Madison, WI 53713-2334 |
Second Address | Janesville, WI 53546-2344 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 13/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200501040 | (05) | IN |
2920361 | (05) | OH |
F17367 | (02) | IN |