Provider Demographics
NPI:1073787339
Name:JOHNSON, KRYSTAL BROWN (MD)
Entity Type:Individual
Prefix:DR
First Name:KRYSTAL
Middle Name:BROWN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:DUKE UNIVERSITY MEDICAL CENTER
Mailing Address - Street 2:DEPT. OF PATHOLOGY BOX 3712
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-684-3858
Mailing Address - Fax:
Practice Address - Street 1:DUKE UNIVERSITY MEDICAL CENTER
Practice Address - Street 2:DEPT. OF PATHOLOGY BOX 3712
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-684-3858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2009-00285207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology