| NPI | 1831719384 | 
|---|---|
| Former Name | JILLIAN R. B. JOHNSON | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024044282) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 23838) | 
| Enumeration Date | 2020-04-24 | 
| Last Update Date | 2025-05-07 |