Provider Demographics
NPI:1669892881
Name:JOHNSON, JESSICA R (APRN)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:R
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:248 PLEASANT ST
Mailing Address - Street 2:SUITE 2800
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2588
Mailing Address - Country:US
Mailing Address - Phone:603-224-4003
Mailing Address - Fax:603-228-7031
Practice Address - Street 1:248 PLEASANT ST
Practice Address - Street 2:#2800
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2588
Practice Address - Country:US
Practice Address - Phone:603-224-4003
Practice Address - Fax:603-228-7031
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH061455-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily