| Doctor Name: | JILL JOHNSON |
| NPI Number: | 1356415574 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 55753 |
| Business Practice Address: | 796 E Charles Page Blvd Sand Springs, OK - 740638507 |
| Business Phone Number: | 9182452286 |
| Business Fax Number: | |
| Mailing Address: | 6600 S Yale Ave, Suite 1400 TULSA |
| State: | OK |
| Postal Code: | 741363310 |
| Phone Number: | 9184886001 |
| Fax Number: | |
| NPI Enumeration Date: | 11/20/2006 |
| NPI Last Update Date: | 03/04/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 55753 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |