Individual
JESSICA JOHNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
5979 DESERT STORM AVE, FORT CAMPBELL, KY 42223-5514
(270) 798-4677
Mailing address
800 CRESTONE LN, CLARKSVILLE, TN 37042-1969
(434) 610-1288
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/15/2021
Last updated
07/15/2021
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