Provider Demographics
NPI:1033898432
Name:EMMA JOHNSON NUTRITIONIST
Entity Type:Organization
Organization Name:EMMA JOHNSON NUTRITIONIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:ALAINA
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS RDN LDN
Authorized Official - Phone:919-452-3979
Mailing Address - Street 1:8012 WHITEGROVE RD
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-1610
Mailing Address - Country:US
Mailing Address - Phone:704-762-1771
Mailing Address - Fax:855-595-2959
Practice Address - Street 1:8012 WHITEGROVE RD
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-1610
Practice Address - Country:US
Practice Address - Phone:704-762-1771
Practice Address - Fax:855-595-2959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-13
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty