| Doctor Name: | JENNIFER JOHNSON |
| NPI Number: | 1144615287 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | 2015007296 |
| Business Practice Address: | 195 Hospital Dr Suite B Cherokee Village, AR - 725297314 |
| Business Phone Number: | 8702576060 |
| Business Fax Number: | 8702577664 |
| Mailing Address: | 195 Hospital Dr, Suite B CHEROKEE VILLAGE |
| State: | AR |
| Postal Code: | 725297314 |
| Phone Number: | 8702576060 |
| Fax Number: | 8702577664 |
| NPI Enumeration Date: | 04/06/2015 |
| NPI Last Update Date: | 05/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2015007296 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |