| Doctor Name: | MS. JENNIFER JEAN JOHNSON |
| NPI Number: | 1023381969 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | R538442 |
| Business Practice Address: | 1654 Hugh Hunter Rd #20 Oak Grove, KY - 42262 |
| Business Phone Number: | 6019274791 |
| Business Fax Number: | |
| Mailing Address: | 1654 Hugh Hunter Rd Apt 20, OAK GROVE |
| State: | KY |
| Postal Code: | 422629159 |
| Phone Number: | 6019274791 |
| Fax Number: | |
| NPI Enumeration Date: | 02/22/2012 |
| NPI Last Update Date: | 02/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R538442 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |