Provider Demographics
NPI:1477843571
Name:JOHNSON, KRISTINA G (MD)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:G
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2550 MOSSIDE BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3514
Mailing Address - Country:US
Mailing Address - Phone:412-457-1100
Mailing Address - Fax:412-457-0250
Practice Address - Street 1:2550 MOSSIDE BLVD STE 500
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3514
Practice Address - Country:US
Practice Address - Phone:412-457-1100
Practice Address - Fax:412-457-0250
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD476881207Q00000X
VA0101256660207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine