Provider Demographics
NPI:1467709253
Name:JOHNSON, ERIKA (MS, RD, CSR)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MS, RD, CSR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8188 MADRILLON CT
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3752
Mailing Address - Country:US
Mailing Address - Phone:703-462-8138
Mailing Address - Fax:
Practice Address - Street 1:8302 OLD COURTHOUSE RD STE C
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3873
Practice Address - Country:US
Practice Address - Phone:703-462-8138
Practice Address - Fax:703-462-8139
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL928007133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered