Individual
JESSICA LYNN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MS
Contact information
Practice address
12401 ACADEMY RD STE 203, PHILADELPHIA, PA 19154-1934
(215) 637-3100
(215) 637-7310
Mailing address
12401 ACADEMY RD STE 203, PHILADELPHIA, PA 19154-1934
(215) 637-3100
(215) 637-7310
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
OA002597
PA
Other
Enumeration date
01/14/2011
Last updated
07/22/2019
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