Johnson, Rebecca A.
Johnson, Rebecca A. is an individual health care provider with primary practice located at 836 Constellation Dr , Decatur GA 30033-2811. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Johnson, Rebecca A. can be contacted via phone (434) 258-6517.Contact Information
Primary practice address
836 Constellation Dr
Decatur GA 30033-2811
Phone: (434) 258-6517
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 0024095207 | Virginia |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | SP01065 | Pennsylvania |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 291053 | Georgia |
Profile Details
| NPI number | 1285636407 |
|---|---|
| LBN Legal business name | Johnson, Rebecca A. |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 1st, 2005 |
| Last updated | Sep 21st, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285636407 | NPPES |
| Other | 010217822 | VA PREMIER PROVIDER NUMBE | |
| Other | 203639329004 | VA PREMIER PROVIDER NUMBE | |
| MEDICAID | 010217822 | VA PREMIER PROVIDER NUMBE |
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