Provider Demographics
NPI:1386987311
Name:JOHNSON, KRISTINA (MS OTRL CLT)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:
Credentials:MS OTRL CLT
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:MACHIRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 JOHN STREET
Mailing Address - Street 2:BOX 42
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:710 NORTH AVE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3258
Practice Address - Country:US
Practice Address - Phone:855-618-2676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201008491225X00000X, 225X00000X
MI2556040201225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand