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Individual
JENNIFER MARIE-SMITH JOHNSON
Active
Individual
JENNIFER MARIE-SMITH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003542
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1010145
HEALTH ADVANTAGE PPO
—
01
—
139492
GREAT LAKES HEALTH PLAN
—
01
—
256
COMMUNITY CHOICE
MI
01
—
2832651
MOLINA HEALTH CARE
MI
01
—
970024194
RAILROAD MEDICARE
—
Enumeration date
10/10/2005
Last updated
04/08/2021
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