Individual
MRS. JESSICA MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
448 OLD CLAIRTON RD, JEFFERSON HILLS, PA 15025-3034
(814) 265-1164
Mailing address
8796 ROUTE 219, BROCKWAY, PA 15824-6010
(814) 265-1164
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP012520
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017167
CRNP PRESCRIPTIVE AUTHORITY
PA
Enumeration date
03/12/2013
Last updated
03/17/2018
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