| NPI | 1053931873 |
|---|---|
| Former Name | JENNIFER R JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704245483) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704245483) |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2024-06-18 |