Individual
JODY L JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
115 SPRING RIDGE DR, MURPHY, TX 75094-4267
(214) 636-1198
(972) 384-0694
Mailing address
115 SPRING RIDGE DR, MURPHY, TX 75094-4267
(214) 636-1198
(972) 384-0694
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
531800
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00Y958
GROUP PROVIDER NUMBER
TX
01
—
1710172093
GROUP NPI NUMBER
TX
Enumeration date
08/19/2007
Last updated
03/15/2011
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