Individual
REBECCA E JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
808 N 3RD ST, GOSHEN, IN 46528
(574) 534-0088
(574) 971-8434
Mailing address
808 N 3RD ST, GOSHEN, IN 46528-7100
(574) 534-0088
(574) 971-8434
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28145472A
IN
367A00000X
Advanced Practice Midwife
Primary
09000270A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201378720
—
IN
Enumeration date
05/16/2016
Last updated
12/31/2020
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