| Doctor Name: | DR. GRETCHEN KRISTINE JOHNSON |
| NPI Number: | 1407936362 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 0101238948 |
| Business Practice Address: | 231 Albert Sabin Way Msb 1554, M.l. 0769 Cincinnati, OH - 452672827 |
| Business Phone Number: | 5135588114 |
| Business Fax Number: | |
| Mailing Address: | 128 Beverly Ave, NORFOLK |
| State: | VA |
| Postal Code: | 235054420 |
| Phone Number: | 7574230623 |
| Fax Number: | |
| NPI Enumeration Date: | 10/16/2006 |
| NPI Last Update Date: | 05/18/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0101238948 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |