Individual
JACQUELINE R JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
100 N UNIVERSITY DR, EDMOND, OK 73034-5207
(405) 974-2317
(405) 974-3832
Mailing address
PO BOX 5199, ABILENE, TX 79608-5199
(325) 437-8300
(325) 437-8399
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0036896
OK
Other
Enumeration date
06/02/2006
Last updated
07/08/2007
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