Johnson, Jaclyn
Johnson, Jaclyn is an individual health care provider with primary practice located at 401 Cypress St , Manchester NH 03103-3628. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Other Service Providers / Specialist. Other Service Providers / Specialist is her primary health care specialty. Johnson, Jaclyn can be contacted via phone (603) 668-4111.Contact Information
Primary practice address
401 Cypress St
Manchester NH 03103-3628
Phone: (603) 668-4111
Fax: (603) 628-7757
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X | ||
| Other Service Providers / Specialist | 174400000X |
Profile Details
| NPI number | 1417195611 |
|---|---|
| LBN Legal business name | Johnson, Jaclyn |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2009 |
| Last updated | Mar 17th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417195611 | NPPES |
| Nebraska | Other | 7706655Y0NH01 | ANTHEM |
| Nebraska | MEDICAID | 99003227 | ANTHEM |
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