Healthcare Provider Details

I. General information

NPI: 1427913920
Provider Name (Legal Business Name): MEREDITH LOGAN JOHNSON WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 HIGHLAND AVE SE STE 303
ROANOKE VA
24013-2253
US

IV. Provider business mailing address

213 S JEFFERSON ST STE 1006
ROANOKE VA
24011-1713
US

V. Phone/Fax

Practice location:
  • Phone: 540-985-9715
  • Fax: 540-985-8487
Mailing address:
  • Phone: 540-224-5516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number0024195714
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: