Individual
JENELLE D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 MEDICAL PARK, WHEELING, WV 26003-6379
(304) 243-3000
Mailing address
3942 GRANDVIEW AVE, SHADYSIDE, OH 43947-1122
(740) 310-6088
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
120992
WV
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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