Provider Demographics
NPI:1902799422
Name:JOHNSON, RHEGAN PAIGE
Entity type:Individual
Prefix:
First Name:RHEGAN
Middle Name:PAIGE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 HERITAGE CENTER DR STE 317
Mailing Address - Street 2:
Mailing Address - City:FURLONG
Mailing Address - State:PA
Mailing Address - Zip Code:18925-1262
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2325 HERITAGE CENTER DR STE 317
Practice Address - Street 2:
Practice Address - City:FURLONG
Practice Address - State:PA
Practice Address - Zip Code:18925-1262
Practice Address - Country:US
Practice Address - Phone:215-874-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant