Provider Demographics
NPI:1164829818
Name:JOHNSON, JEAN (RN (BSN))
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RN (BSN)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 WISCONSIN AVE N.W.
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007
Mailing Address - Country:US
Mailing Address - Phone:202-289-1201
Mailing Address - Fax:202-587-1395
Practice Address - Street 1:1010 WISCONSIN AVE N.W.
Practice Address - Street 2:SUITE 300
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007
Practice Address - Country:US
Practice Address - Phone:202-289-1201
Practice Address - Fax:202-587-1395
Is Sole Proprietor?:No
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN34153163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse