Provider Demographics
NPI:1386606341
Name:JOHNSON, RHONDA RENEE (DNP, CNM)
Entity type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:RENEE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 BEVERLY DR
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-4589
Mailing Address - Country:US
Mailing Address - Phone:907-250-6425
Mailing Address - Fax:
Practice Address - Street 1:519 BEVERLY DR
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-4589
Practice Address - Country:US
Practice Address - Phone:907-250-6425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3034176B00000X, 363L00000X
VA0024173482367A00000X
TN34010367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No176B00000XOther Service ProvidersMidwife
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife