Doctor Name: | RHONDA JOHNSON |
NPI Number: | 1639536782 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | A004615 |
Business Practice Address: | 5787 Highway 64 Parkin, AR - 723739003 |
Business Phone Number: | 8707552234 |
Business Fax Number: | 8707552260 |
Mailing Address: | Po Box 497, AUGUSTA |
State: | AR |
Postal Code: | 720060497 |
Phone Number: | 8703472534 |
Fax Number: | 8703473492 |
NPI Enumeration Date: | 01/20/2016 |
NPI Last Update Date: | 03/17/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | A004615 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |