NPI 1093123069 · live from the CMS NPI Registry
Courtny Johnson
Podiatrist in Providence, RI. National Provider Identifier 1093123069, active.
NPI record
| NPI | 1093123069 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist 213E00000X |
| Practice location | 825 Chalkstone Ave, Providence, RI 02908 |
| Practice phone | 401-456-2000 |
| Enumerated | July 23, 2014 |
| Last updated | December 16, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist primary | 213E00000X | LPR00142 (RI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.