| NPI | 1043656564 |
|---|---|
| Former Name | JODI L JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704247113) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: TN 16471) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2019-01-11 |