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General NPI Number Information
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NPI Number | 1215815899
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Entity Type | Individual
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Provider Name | RYAN SCOTT JOHNSON RNFA
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Gender | Male
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Dates
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Enumeration Date | 08/22/2025
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 1825 LOGAN AVE
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City | WATERLOO
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State | IA
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Zip | 50703-1916
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Country | US
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Telephone | 319-325-3613
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Fax |
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Provider Business Mailing Address
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Address Line | 505 DOWNING AVE
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City | WATERLOO
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State | IA
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Zip | 50701-2434
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Country | US
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Telephone | 319-415-8421
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 152421
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 152421
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License Number State | IA
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