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Individual

MS. REBECCA A. JOHNSON

Active
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Individual

MS. REBECCA A. JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024095207
VA
363LF0000X
Family Nurse Practitioner
Primary
291053
GA
363LF0000X
Family Nurse Practitioner
SP01065
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010217822
VA PREMIER PROVIDER NUMBE
—
05
—
010217822
—
VA
01
—
203639329004
TRICARE PROVIDER NUMBER
—
Enumeration date
06/01/2005
Last updated
09/21/2022
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