Individual
MRS. JILL SUSAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
600 OLD FRANKFORT CIR, LEXINGTON, KY 40510-9689
(859) 253-1686
Mailing address
600 OLD FRANKFORT CIR, LEXINGTON, KY 40510-9689
(859) 253-1686
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
2020402
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
06/28/2022
Last updated
06/28/2022
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