Provider Demographics
NPI:1730401027
Name:JOHNSON, RENE' P (CD)
Entity type:Individual
Prefix:
First Name:RENE'
Middle Name:P
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 80117
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70898-0117
Mailing Address - Country:US
Mailing Address - Phone:225-768-7686
Mailing Address - Fax:
Practice Address - Street 1:8008 BLUEBONNET BLVD
Practice Address - Street 2:8-7
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-7800
Practice Address - Country:US
Practice Address - Phone:225-768-7686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-27
Last Update Date:2010-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula