Individual
JENNIFER DENISE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
1600 E REED RD, GREENVILLE, MS 38703-7229
(662) 580-0635
(662) 580-0569
Mailing address
1600 E REED RD, GREENVILLE, MS 38703-7229
(662) 580-0635
(662) 580-0569
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
878314
MS
163WC1500X
Community Health Registered Nurse
878314
MS
163WM0705X
Medical-Surgical Registered Nurse
878314
MS
Other
Enumeration date
02/15/2019
Last updated
11/15/2022
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