Individual
MS. JENNIFER LYNN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
80 SEYMOUR ST, HARTFORD, CT 06106-3300
(860) 545-5000
Mailing address
99 EAST RIVER DRIVE, 5TH FLOOR, EAST HATFORD, CT 06108-7301
(860) 282-0833
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2002014117
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159253001
—
AR
01
—
431560263069
TRICARE
—
05
—
917262909
—
MO
Enumeration date
07/05/2005
Last updated
12/01/2023
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