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Individual

JESSICA N JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP-PC

Contact information

Practice address
514 W ATLANTIC ST, SOUTH HILL, VA 23970-1906
(434) 584-2000
Mailing address
516 W ATLANTIC ST, SOUTH HILL, VA 23970-1906
(434) 584-2000

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0024179441
VA
363LP0200X
Pediatric Nurse Practitioner
5013872
NC

Other

Enumeration date
10/08/2020
Last updated
02/22/2022
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