Provider Demographics
NPI:1659651891
Name:JOHNSON, LINDA WEIS (RD, MPH, LDN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:WEIS
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RD, MPH, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HOSPITAL ROAD
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE
Mailing Address - State:NC
Mailing Address - Zip Code:28719-0268
Mailing Address - Country:US
Mailing Address - Phone:828-497-9163
Mailing Address - Fax:828-497-1723
Practice Address - Street 1:1 HOSPITAL ROAD
Practice Address - Street 2:
Practice Address - City:CHEROKEE
Practice Address - State:NC
Practice Address - Zip Code:28719-0268
Practice Address - Country:US
Practice Address - Phone:828-497-9163
Practice Address - Fax:828-497-1723
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000485133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered