Johnson, Jennifer Diane

Johnson, Jennifer Diane is an individual health care provider with primary practice located at 725 American Avenue , Waukesha WI 53188. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Johnson, Jennifer Diane can be contacted via phone (212) 928-8800.

Contact Information

Primary practice address
725 American Avenue Waukesha WI 53188
Phone: (212) 928-8800
Fax: (262) 928-0648
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 6088-33 Wisconsin
Nursing Service Providers / Registered Nurse 163W00000X 171464-30 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 6088-33 Wisconsin

Profile Details

NPI number 1043615560
LBN Legal business name Johnson, Jennifer Diane
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2014
Last updated Dec 12th, 2024 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043615560 NPPES
Wisconsin MEDICAID 100041913

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