Individual
MS. JESSICA S JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MNT
Contact information
Practice address
300 SOUTH MAIN STREET, BROOKSVILLE, FL 34601-3320
(352) 540-6800
(352) 754-4132
Mailing address
300 SOUTH MAIN STREET, BROOKSVILLE, FL 34601-3320
(352) 540-6800
(352) 754-4132
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
898669
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
898669
CRD
IL
Enumeration date
04/24/2008
Last updated
04/24/2008
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