Doctor Name: | REBECCA LOGAN JOHNSON |
NPI Number: | 1659588135 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | R0212 |
Business Practice Address: | 2050 Versailles Rd Lexington, KY - 405041405 |
Business Phone Number: | 8593677127 |
Business Fax Number: | |
Mailing Address: | 2200 Fords Mill Rd, VERSAILLES |
State: | KY |
Postal Code: | 403838929 |
Phone Number: | 8598730836 |
Fax Number: | |
NPI Enumeration Date: | 05/16/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | R0212 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |