Most Relevant Information
Provider Data
| NPI Number: | 1003401449 |
| Provider Name: | REBECCA RAE JOHANSEN NP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | A157622 |
Most Important Dates
| Enumeration Date: | 03/08/2021 |
| Last Updated: | 06/22/2022 |
Provider Practice Location
1215 PLEASANT ST STE 308
DES MOINES
IA
503091409
Practice Location Phone/Fax
| Phone: | 5152414325 |
| Fax: |
Provider Mailing Location
1215 PLEASANT ST STE 308
DES MOINES
IA
503091409
Provider Mailing Phone/Fax
| Phone: | 5152414325 |
| Fax: |