Provider Demographics
NPI:1588191506
Name:JOHNSON, ERIN KOLBERG (AUD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:KOLBERG
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3313 HEDGEROW CIR
Mailing Address - Street 2:
Mailing Address - City:TRENT WOODS
Mailing Address - State:NC
Mailing Address - Zip Code:28562-6612
Mailing Address - Country:US
Mailing Address - Phone:478-973-4990
Mailing Address - Fax:
Practice Address - Street 1:5000 US HIGHWAY 70 W STE 103
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4531
Practice Address - Country:US
Practice Address - Phone:252-773-0636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-22
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10093231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist