Individual
MRS. REBECCA ELY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1508 3RD AVE. EAST, BIG STONE GAP, VA 24219
(276) 523-0599
(276) 523-4690
Mailing address
P.O. BOX 888, BIG STONE GAP, VA 24219
(276) 523-0599
(276) 523-4690
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
0001065115
VA
Other
Enumeration date
09/20/2012
Last updated
09/20/2012
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