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Organization
JOHNSON RIVERSIDE FAMILY PRACTICE LLC
Active
Organization
JOHNSON RIVERSIDE FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER NICHOLE JOHNSON FNP (APRN)
(863) 946-0284
Entity
Organization
Contact information
Practice address
43 AVENUE J, MOORE HAVEN, FL 33471
(863) 599-1620
Mailing address
43 AVENUE J SW, MOORE HAVEN, FL 33471-2116
(863) 946-0284
(863) 946-0794
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
08/02/2021
Last updated
10/11/2022
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