Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Corey Dewite Johnson Sr., DIETARYMANAGER

Individual provider Driver · NPI 1740029792

Mr. Corey Dewite Johnson Sr., DIETARYMANAGER is a Driver in Kansas City, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2024

Practice location Address checks out

3442 Wabash Ave
Kansas City, MO 64109-2539
Phone: (816) 215-0334
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Driver (primary) Taxonomy 172A00000X · Licence J125035005 (MO)

Record details

NPI number1740029792
Entity typeIndividual (Type 1)
GenderMale
Credentials DIETARYMANAGER
Sole proprietorYes
NPI enumeratedMay 20, 2024
Last updated in NPPESMay 20, 2024
Certification dateMay 20, 2024

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