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Individual

JESSICA JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3303 DUVAL ST, JUPITER, FL 33458-8259
(561) 248-6875
Mailing address
3303 DUVAL ST, JUPITER, FL 33458-8259
(561) 248-6875

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2827222
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2827222
STATE BOARD
FL
Enumeration date
02/20/2019
Last updated
02/20/2019
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