| Doctor Name: | SUSAN K JOHNSON |
| NPI Number: | 1164447512 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 0024166977 |
| Business Practice Address: | 18765 Riverside Dr Vansant, VA - 24656 |
| Business Phone Number: | 2769352880 |
| Business Fax Number: | 2769352889 |
| Mailing Address: | Po Box 498, KEEN MOUNTAIN |
| State: | VA |
| Postal Code: | 24624 |
| Phone Number: | 2769352880 |
| Fax Number: | 2769352889 |
| NPI Enumeration Date: | 07/13/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 0024166977 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |