Provider Demographics
NPI:1942470943
Name:JOHNSON, EMILY A (RD, LD, DE)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:A
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RD, LD, DE
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:CHURCHILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2997
Mailing Address - Country:US
Mailing Address - Phone:603-926-1119
Mailing Address - Fax:603-926-0896
Practice Address - Street 1:118 PORTSMOUTH AVE STE A101
Practice Address - Street 2:
Practice Address - City:STRATHAM
Practice Address - State:NH
Practice Address - Zip Code:03885-4438
Practice Address - Country:US
Practice Address - Phone:603-926-1119
Practice Address - Fax:603-926-0896
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0496133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered