Individual
JENNIFER ARTEMIS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
109 REID RD, JUNCTION, TX 76849-3008
(325) 446-3305
Mailing address
2101 MAIN ST, JUNCTION, TX 76849-3024
(325) 446-3305
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA03207
TX
363AM0700X
Medical Physician Assistant
Primary
PA03207
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
741622343
TAX ID#
TX
Enumeration date
07/24/2006
Last updated
02/22/2010
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