Doctor Name: | DR. KAREN BARBARA JOHANSEN |
NPI Number: | 1780781575 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | D41221 |
Business Practice Address: | Lrmc Cmr 402 Box 816 Apo, AE - 09180 |
Business Phone Number: | 001496371495578 |
Business Fax Number: | |
Mailing Address: | Lrmc, Cmr 402 Box 816 APO |
State: | AE |
Postal Code: | 09180 |
Phone Number: | 001496371495578 |
Fax Number: | |
NPI Enumeration Date: | 09/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171000000X |
License Number: | D41221 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Military Health Care Provider |
Taxonomy Specialization: | |
Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |