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NPI Code Detail

MEDICARE: RONDA JOHNSON NP

MEDICARE:   RONDA  JOHNSON  NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner5011974NC
2363L00000XNurse Practitioner0024193230VA
3363LA2100XAcute Care Nurse Practitioner3011777KY
4363LC0200XCritical Care Medicine Nurse Practitioner3011777KY
5363L00000XNurse Practitioner21288SC
6363L00000XNurse Practitioner3011777KY

General Provider Information

NPI Number : 1407368848
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONDA JOHNSON NP
Provider Business Mailing Address
First Line : PO BOX 776351
Second Line :
City : CHICAGO
State : IL
Zip : 60677-6351
Country : US
Telephone Number : 502-588-9490
Fax Number : 502-272-5339
Provider Business Practice Location Address
First Line : 6420 DUTCHMANS PKWY STE 200
Second Line :
City : LOUISVILLE
State : KY
Zip : 40205-3373
Country : US
Telephone Number : 502-891-8300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2017
Last Update Date : 05/19/2026

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