Individual
JESSICA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.
Contact information
Practice address
5555 S LEWIS AVE, TULSA, OK 74105-7104
(918) 216-0450
(918) 205-9036
Mailing address
56478 S 590 RD, KANSAS, OK 74347-1654
(918) 718-0911
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/12/2019
Last updated
11/12/2019
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