Individual
JASON V JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
208 MEDICAL PARK BLVD, BRISTOL, TN 37620-7343
(423) 989-4050
(423) 990-3044
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 989-4050
(423) 990-3044
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
22963
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q032510
—
TN
Enumeration date
08/15/2017
Last updated
01/18/2024
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