| NPI | 1013326867 | 
|---|---|
| Former Name | JENNIFER LYNN JOHNSON | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: CT 6646)  | 
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: NY F430842-1)  | 
| Enumeration Date | 2014-08-06 | 
| Last Update Date | 2018-09-10 |