Individual
JESSICA ALICE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 697-3600
Mailing address
10140 CENTURION PKWY N, JACKSONVILLE, FL 32256-0532
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11000755
FL
363LF0000X
Family Nurse Practitioner
RN9321916
FL
Other
Enumeration date
11/25/2018
Last updated
11/20/2019
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