Individual
JILL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2521 UNIVERSITY BLVD STE 121, AMES, IA 50010-8629
(515) 241-0982
Mailing address
1301 PENN AVE, DES MOINES, IA 50316-2350
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002345
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01353134
RR MEDICARE
IA
Enumeration date
09/18/2013
Last updated
01/31/2025
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