Provider Demographics
NPI:1063702397
Name:JOHNSON, RHONDA MICHELLE (RN BSN)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:MICHELLE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:482 DEERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HILLSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24343-5065
Mailing Address - Country:US
Mailing Address - Phone:276-766-3462
Mailing Address - Fax:
Practice Address - Street 1:482 DEERFIELD RD
Practice Address - Street 2:
Practice Address - City:HILLSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24343-5065
Practice Address - Country:US
Practice Address - Phone:276-766-3462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001148826163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine