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NPI Code Detail

MEDICARE: JESSICA JOHNSON SLP

MEDICARE: JESSICA JOHNSON SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianNE
2235Z00000XSpeech-Language Pathologist1519NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225375355
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA JOHNSON SLP
Provider Business Mailing Address
First Line : 13336 INDUSTRIAL RD
Second Line : SUITE 105
City : OMAHA
State : NE
Zip : 68137-1124
Country : US
Telephone Number : 402-330-3211
Fax Number : 402-330-5970
Provider Business Practice Location Address
First Line : 819 TARA PLZ
Second Line :
City : PAPILLION
State : NE
Zip : 68046-2043
Country : US
Telephone Number : 907-206-4450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2013
Last Update Date : 06/18/2026

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