Provider Demographics
NPI:1770976250
Name:JOHNSON, EMILY R (CD(DONA))
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:R
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 FRIARS LN APT 4
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-4563
Mailing Address - Country:US
Mailing Address - Phone:859-322-3399
Mailing Address - Fax:
Practice Address - Street 1:600 FRIARS LN APT 4
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4563
Practice Address - Country:US
Practice Address - Phone:859-322-3399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9467374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula