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General NPI Number Information
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NPI Number | 1285957308
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Entity Type | Individual
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Provider Name | REBECCA G JOHNSON CNM
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Gender | Female
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Dates
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Enumeration Date | 03/03/2010
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Last Update Date | 09/28/2018
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Provider Practice Location Address
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Address Line | 1532 LONE OAK RD STE 245
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City | PADUCAH
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State | KY
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Zip | 42003-7941
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Country | US
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Telephone | 270-538-5700
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Fax | 270-538-5701
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Provider Business Mailing Address
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Address Line | 1532 LONE OAK RD STE 245
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City | PADUCAH
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State | KY
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Zip | 42003-7941
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Country | US
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Telephone | 270-538-5700
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Fax | 270-538-5701
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 3006383
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 3006383
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | APN16127
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 6383M
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 3006383
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License Number State | KY
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