| Doctor Name: | MRS. ERNESTINE VALERIE JOHNSON |
| NPI Number: | 1629377833 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 2011-240443-R |
| Business Practice Address: | 5220 Settlers Park Drive Virginia Beach, VA - 23464 |
| Business Phone Number: | 7573553377 |
| Business Fax Number: | 7572167001 |
| Mailing Address: | 5220 Settlers Park Drive, VIRGINIA BEACH |
| State: | VA |
| Postal Code: | 23464 |
| Phone Number: | 7573554464 |
| Fax Number: | 7572167001 |
| NPI Enumeration Date: | 03/28/2011 |
| NPI Last Update Date: | 07/14/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 2011-240443-R |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |