Individual
JONNAE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1150 GRAHAM RD STE 101, FLORISSANT, MO 63031-8077
(314) 206-3900
Mailing address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3700
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2022000382
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0606256669
RN
MO
Enumeration date
05/10/2022
Last updated
05/10/2022
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