| NPI | 1588129134 |
|---|---|
| Former Name | KRISTA NICOLE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2021024162) |
| Enumeration Date | 2019-02-07 |
| Last Update Date | 2025-04-18 |