Healthcare Provider Details

I. General information

NPI: 1720729254
Provider Name (Legal Business Name): REBECCA ANN JOHNS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2022
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 E UNIVERSITY DR STE 200
MESA AZ
85203-8308
US

IV. Provider business mailing address

4207 N 78TH WAY
SCOTTSDALE AZ
85251-4112
US

V. Phone/Fax

Practice location:
  • Phone: 480-999-7911
  • Fax: 480-499-5829
Mailing address:
  • Phone: 480-300-9505
  • Fax: 480-781-4862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number280161
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN152911
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: