Individual
REBECCA L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
120 W LINCOLN AVE, AVA, MO 65608
(417) 683-6790
(417) 683-6770
Mailing address
PO BOX 865, AVA, MO 65608-0865
(417) 683-6790
(417) 683-6770
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A003828
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196066758
—
AR
Enumeration date
02/06/2013
Last updated
08/25/2023
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