| Doctor Name: | MRS. KATHLEEN M JOHNSON |
| NPI Number: | 1538436803 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 312427 |
| Business Practice Address: | 215 Old Riverhead Rd Westhampton Beach, NY - 119781206 |
| Business Phone Number: | 6312886515 |
| Business Fax Number: | |
| Mailing Address: | 114 Lake Ave, CENTER MORICHES |
| State: | NY |
| Postal Code: | 119342527 |
| Phone Number: | 6318747039 |
| Fax Number: | |
| NPI Enumeration Date: | 11/30/2011 |
| NPI Last Update Date: | 11/30/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | 312427 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |