Individual
JACQUELINE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
81-4360797
TX
164X00000X
Licensed Vocational Nurse
81-4360797
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
AP143029
TX
376K00000X
Nurse's Aide
81-4360797
TX
Other
Enumeration date
11/27/2016
Last updated
05/25/2026
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