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Individual

JESLYN A. JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
20375 W 151ST ST, SUITE 306, OLATHE, KS 66061-5306
(913) 782-2292
(913) 782-2381
Mailing address
20375 W 151ST ST, SUITE 306, OLATHE, KS 66061-5306
(913) 782-2292
(913) 782-2381

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
96296
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
557027
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200733680A
KS
01
P00970186
RR MEDICARE
KS
Enumeration date
04/28/2011
Last updated
03/28/2014
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