Individual
JENNIFER MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
PO BOX 507, GARY, WV 24836-0507
(304) 448-2101
Mailing address
1675 STEWART ST, WELCH, WV 24801-2142
(304) 888-0514
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
97296
WV
363LF0000X
Family Nurse Practitioner
Primary
119260
WV
Other
Enumeration date
05/02/2024
Last updated
04/23/2025
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