Individual
JESSILYN MAE JOHANNSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2720 STONE PARK BLVD, SIOUX CITY, IA 51104-3734
(712) 279-3750
Mailing address
4701 46TH ST, SIOUX CITY, IA 51108-1548
(712) 560-6686
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
126879
IA
363L00000X
Nurse Practitioner
Primary
A185562
IA
Other
Enumeration date
06/19/2024
Last updated
04/28/2026
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