Individual
MS. JACQUELINE BROOKE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
430 MORTON PLANT ST, SUITE 301, CLEARWATER, FL 33756-3395
(727) 461-6026
(727) 461-1492
Mailing address
430 MORTON PLANT ST, SUITE 301, CLEARWATER, FL 33756-3395
(727) 461-6026
(727) 461-1492
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 9109476
FL
Other
Enumeration date
07/15/2016
Last updated
10/13/2016
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