Individual
MISS JACQUELINE LYNN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4919 GRAND AVE, OMAHA, NE 68104-2380
(402) 850-5153
Mailing address
4919 GRAND AVE, OMAHA, NE 68104-2380
(402) 850-5153
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
G01220844
NE
372600000X
Adult Companion
G01220844
NE
Other
Enumeration date
11/17/2025
Last updated
11/17/2025
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