Provider Demographics
NPI:1144515057
Name:STEWART- JOHNSON, RACHEL P (CRNA)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:P
Last Name:STEWART- JOHNSON
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:196 THOMAS JOHNSON DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4397
Mailing Address - Country:US
Mailing Address - Phone:301-668-9988
Mailing Address - Fax:301-668-9977
Practice Address - Street 1:5 GARRETT AVE
Practice Address - Street 2:POST OFFICE BOX 1070
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-5960
Practice Address - Country:US
Practice Address - Phone:301-609-4285
Practice Address - Fax:301-934-6958
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDR133908367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered