| NPI | 1659617173 |
|---|---|
| Former Name | JESSICA L JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND R33813) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2013-01-03 |
| Last Update Date | 2024-02-02 |