Provider Demographics
NPI:1265013643
Name:JOHNSON, REBEKAH DRU (DNP, FNP, RN)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:DRU
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DNP, FNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1546 VINEYARD DR
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-1357
Mailing Address - Country:US
Mailing Address - Phone:801-660-5645
Mailing Address - Fax:801-992-1218
Practice Address - Street 1:270 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-6257
Practice Address - Country:US
Practice Address - Phone:801-683-9340
Practice Address - Fax:801-992-1218
Is Sole Proprietor?:No
Enumeration Date:2021-04-18
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1265013643363LF0000X
UT313830-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily