Individual
MRS. JOLENE LALLISS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.N.P.
Contact information
Practice address
100 N MEDICAL DR, SALT LAKE CITY, UT 84113-1103
(801) 662-4100
Mailing address
583 N 200 E, BOUNTIFUL, UT 84010-4642
(801) 296-2624
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
3221574405
UT
Other
Enumeration date
12/10/2007
Last updated
12/10/2007
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