Provider Demographics
NPI:1912094624
Name:JOHNSON, JANICA W (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JANICA
Middle Name:W
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:63 E 1340 N
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-3724
Mailing Address - Country:US
Mailing Address - Phone:801-492-6398
Mailing Address - Fax:801-492-6399
Practice Address - Street 1:1550 E 3400 N
Practice Address - Street 2:HOFFMAN CONSTRUCTION
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-9692
Practice Address - Country:US
Practice Address - Phone:801-767-3451
Practice Address - Fax:801-767-3651
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT204541-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily