Individual
JENNIFER ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1500 PHYSICIANS DR, WILMINGTON, NC 28401-7356
(910) 662-9500
(910) 662-9501
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
(910) 662-9500
(910) 662-9501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103040
NC
363AM0700X
Medical Physician Assistant
103040
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970025601
RAILROAD MEDICARE
NC
Enumeration date
10/05/2006
Last updated
03/15/2022
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