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Individual
MISS JENNIFER LYNN JOHNSON
Active
Individual
MISS JENNIFER LYNN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN190791
GA
363L00000X
Nurse Practitioner
Primary
RN190791
GA
Other
Enumeration date
01/29/2013
Last updated
02/14/2013
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