Individual
JESSICA TYNEA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
115 DUNMORELAND ST, SPRINGFIELD, MA 01109-3261
(413) 219-3689
Mailing address
115 DUNMORELAND ST, SPRINGFIELD, MA 01109-3261
(413) 219-3689
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
RN2388726
MA
Other
Enumeration date
09/17/2021
Last updated
01/31/2025
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