Healthcare Provider Details

I. General information

NPI: 1477690634
Provider Name (Legal Business Name): RONNA MICHELLE JOHNSON RN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 04/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7968 COOLEY RD
RAVENNA OH
44266-9753
US

IV. Provider business mailing address

702 E MARKET ST
AKRON OH
44305-2422
US

V. Phone/Fax

Practice location:
  • Phone: 330-296-7479
  • Fax:
Mailing address:
  • Phone: 330-434-4141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN-167932
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.06233
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: