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 |