Individual
JENNIFER M JOHANNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
CDRH.0059996
CO
208600000X
Surgery Physician
OP60649442
WA
Other
Enumeration date
07/01/2011
Last updated
06/27/2024
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