Johnson, Kelly Cooke

Johnson, Kelly Cooke is an individual health care provider with primary practice located at 3024 New Bern Ave , Raleigh NC 27610-1247. She recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Audiologist, Speech, Language and Hearing Service Providers / Audiology Assistant. Speech, Language and Hearing Service Providers / Audiologist is her primary health care specialty. Johnson, Kelly Cooke can be contacted via phone (919) 350-7856.

Contact Information

Primary practice address
3024 New Bern Ave Raleigh NC 27610-1247
Phone: (919) 350-7856
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X North Carolina
Speech, Language and Hearing Service Providers / Audiology Assistant 2355A2700X
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 14997 North Carolina

Profile Details

NPI number 1568039378
LBN Legal business name Johnson, Kelly Cooke
Credentials AUD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2021
Last updated Jul 23rd, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568039378 NPPES
North Carolina MEDICAID 1568039378

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