Organization
JENNIFER JOHNSTAD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER ANNE JOHNSTAD (PHYSICIAN ASSISTANT)
(480) 512-3970
Entity
Organization
Contact information
Practice address
2421 E SOUTHERN AVE, SUITE 1, TEMPE, AZ 85282-7612
(480) 485-2158
(480) 839-4727
Mailing address
2421 E SOUTHERN AVE, SUITE 1, TEMPE, AZ 85282-7612
(480) 485-2158
(480) 839-4727
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2492
AZ
Other
Enumeration date
12/10/2008
Last updated
08/21/2009
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