Provider Demographics
NPI:1568480580
Name:JOHNS, JENNIFER JONE (R, CT, MR)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JONE
Last Name:JOHNS
Suffix:
Gender:F
Credentials:R, CT, MR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 W 19TH ST
Mailing Address - Street 2:UNIT 28C
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4119
Mailing Address - Country:US
Mailing Address - Phone:850-913-8348
Mailing Address - Fax:
Practice Address - Street 1:511 E 23RD ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-5307
Practice Address - Country:US
Practice Address - Phone:850-747-8822
Practice Address - Fax:850-747-8664
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCRT51007247100000X
3246112471C3401X, 2471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist
Not Answered2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed Tomography
Not Answered2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging