Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 21288 | SC |
Y | 363L00000X | Nurse Practitioner | 3011777 | KY |
N | 363L00000X | Nurse Practitioner | 5011974 | NC |
N | 363LA2100X | Nurse Practitioner - Acute Care | 3011777 | KY |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 3011777 | KY |
NPI | 1407368848 |
---|---|
Provider Name | Ronda Johnson |
First Address | Louisville, KY 40201-0909 |
Second Address | Louisville, KY 40202-3841 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2017 |
Last Update Date | 27/07/2021 |