Individual
RENE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
173 SAINT PATRICKS DR STE 104, WALDORF, MD 20603-5530
(888) 731-8994
Mailing address
173 SAINT PATRICKS DR STE 104, WALDORF, MD 20603-5530
(888) 731-8994
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R134332
MD
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
R134332
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
058443600
—
MD
Enumeration date
03/18/2010
Last updated
05/07/2025
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