Individual
MS. JESSICA MICHELLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
110A SPRINGHALL DR, GOOSE CREEK, SC 29445-5335
(843) 779-6444
(843) 990-5068
Mailing address
1593 KENTWOOD CIR, CHARLESTON, SC 29412-9383
(843) 834-9837
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3179
SC
Other
Enumeration date
08/07/2019
Last updated
09/01/2020
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