Provider Demographics
NPI:1700293602
Name:JOHNSON, RHONDA (ARNP)
Entity Type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12700 BARTRAM PARK BLVD
Mailing Address - Street 2:APT 1420
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-5406
Mailing Address - Country:US
Mailing Address - Phone:904-554-1728
Mailing Address - Fax:
Practice Address - Street 1:1543 KINGSLEY AVE STE 9
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4583
Practice Address - Country:US
Practice Address - Phone:904-264-1958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-13
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9286772363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics