Individual
JESSICA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
10105798-1205
UT
207RI0200X
Infectious Disease Physician
Primary
10105798-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2015
Last updated
10/21/2021
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