| Doctor Name: | MRS. REBECCA ELY JOHNSON |
| NPI Number: | 1366793002 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 0001065115 |
| Business Practice Address: | 1508 3rd Ave. East Big Stone Gap, VA - 24219 |
| Business Phone Number: | 2765230599 |
| Business Fax Number: | 2765234690 |
| Mailing Address: | P.o. Box 888, BIG STONE GAP |
| State: | VA |
| Postal Code: | 24219 |
| Phone Number: | 2765230599 |
| Fax Number: | 2765234690 |
| NPI Enumeration Date: | 09/20/2012 |
| NPI Last Update Date: | 09/20/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0809X |
| License Number: | 0001065115 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |