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Deondre M Johnson
Student in an Organized Health Care Education/Training Program in Bridgewater, Virginia
NPI 1871141994

Deondre M Johnson is a Student in an Organized Health Care Education/Training Program based in Wake Forest, VA. Deondre M Johnson practices in Bridgewater, VA. The NPI Number for Deondre M Johnson is 1871141994 and holds a License No. (Virginia).

The current practice location address for Deondre M Johnson is 402 E College St, Bridgewater, VA and can be reached out via phone at 919-527-4148.

Location: 402 E College St, Bridgewater, VA, 27587-6355
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1871141994
Provider Name
Deondre M Johnson
Credential
Provider Entity Type
Individual
Gender
Male
Address
402 E College St, Bridgewater, VA, 27587-6355
Phone Number
919-527-4148
Fax Number
Provider Enumeration Date
09/02/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
U6174564304 01 CIGNA
institution
Provider Business Practice Location Address Details
Address
402 E College St
City
Bridgewater
State
Virginia
Zip
22812-1511
Phone Number
919-527-4148
Fax Number
person
Provider Business Mailing Address Details
Address
402 E College St
City
Bridgewater
State
Virginia
Zip
22812-1511
Phone Number
919-527-4148
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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