Individual
JENNIFER MICHELLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA, MSN
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 791-2000
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
109408
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
18028
SC
367500000X
Certified Registered Nurse Anesthetist
RN223350
GA
Other
Enumeration date
01/04/2012
Last updated
11/09/2020
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